Core pharmacology

Class Group

ANTIBIOTIC:
LINCOSAMIDE

Legacy Cicm Level

Level 3

Introduction

Lincosamide

Indications Uses

• Clindamycin is used to treat serious anaerobic and gram positive infection (not enterococcus) and also has MRSA and Plasmodium falciparum cover (but not p. vivax or gram negative aerobes)
• Can be used (along with primaquine) to treat PCP
• Can be used to treat toxin mediated septic syndromes including necrotizing fasciitis and toxic shock syndrome
• MOA: inhibits bacterial synthesis by disrupting the function of 50S ribosomal subunit. Can be bacteriostatic or bacteriocidal depending on concentration and microbe being treated

Mechanism of action

Inhibitor of bacterial 50S ribosomal subunit

Prevents protein synthesis

Antimicrobial Spectrum

Aerobic G+ cocci including MRSA (except enterococci)

Anaerobic G- bacilli

Most aerobic G- bacilli are resistant including pseudomonas (except Capnocytophagia canimorus)

Adverse Effects Toxicity

- Pseudomembranous colitis due to c.diff
- Contact dermatitis
- Metallic taste
- Anaphylaxis

Absorption

IV or PO

Distribution

Wide distribution including bone but not CSF

Protein binding

90% PB

Metabolism

Hepatic metabolism

Excretion

Biliary. Long post antibiotic effect leads to clostridium overgrowth