This document discusses the lincosamide antibiotics clindamycin and lincomycin. Clindamycin is a potent lincosamide antibiotic that inhibits protein synthesis by binding to the 50s ribosome. It has a similar spectrum of activity to erythromycin and is effective against most gram-positive cocci, diphtheria, nocardia, and actinomyces. Common side effects include rashes, diarrhea, and pseudomembranous colitis caused by C. difficile infection. Clindamycin is restricted to anaerobic infections and is used for Bacteroides fragilis infections of the abdomen, pelvis, and lungs. Lincomycin was the predecessor to cl

1. LINCOSAMIDE
ANTIBIOTICS
Anusha Shaji, B.Pharm, M.Pharm
Assistant Professor
Department of Pharmacology
Nirmala College of Pharmacy,
Muvattupuzha, Ernakulam

2. CLINDAMYCIN
Potent lincosamide antibiotic
MOA: Inhibit protein synthesis by binding to 50s ribosome
Similar in spectrum of activity to erythromycin
Clindamycin inhibits most gram positive cocci, C. diphtheriae,
Nocardia, Actinomyces and Toxoplasma
It has slow action on Plasmodia
Pharmacokinetics
Oral absorption of clindamycin is good
It penetrates into most skeletal and soft tissues, but not in brain and
CSF

3. Accumulates in neutrophils and macrophages
It is largely metabolized and metabolites are excreted in urine and bile
Plasma half life: 3 hours
Side effects
Rashes, urticaria and abdominal pain
Diarrhoea
Pseudomembranous enterocolitis due to Clostridium difficile
superinfection which is potentially fatal → the drug should be promptly
stopped and oral metronidazole (alternatively vancomycin) given to treat
it
Thrombophlebitis of the injected vein can occur on i.v. administration

4. Uses
Because of the potential toxicity → use of clindamycin is restricted to
anaerobic and mixed infections
Used for Bact. fragilis causing abdominal, pelvic and lung abscesses
↓
It is a first line drug for these conditions, and is generally combined
with an aminoglycoside or a cephalosporin
Metronidazole and chloramphenicol are the alternatives to
clindamycin for covering the anaerobes
Skin and soft tissue infections in patients allergic to penicillins can be
treated with clindamycin

5. LINCOMYCIN
It is the forerunner of clindamycin
Similar antibacterial and toxic properties
Less potent and produces a higher incidence of diarrhoea and colitis-
death have occured
↓
Thus, it has been largely replaced by clindamycin
Pharmacokinetics
It is absorbed orally and excreted mainly in bile
Plasma half life: 5 hours
Dose: 500 mg TDS-QID oral, 600 mg i.m. or by i.v. infusion 6-12
hrly