Lincomycin is one of the lincosamide antibiotics used to treat bacterial infections. It was developed from the biological product of a species of actinomycetes called Streptomyces lincolnensis. With chemical modification by thionyl chloride, lincomycin becomes clindamycin. The mechanism of action and the bacterial coverage of this drug are similar to that of macrolides, which means it inhibits protein synthesis by binding the 50 Svedberg (50S) ribosomal subunit, and it is active against many gram-positive cocci and bacilli, and some gram-negative cocci. It is not used as a first-line treatment anymore because of the risk of adverse reactions and the availability of safer drugs.
Like the macrolide erythromycin and the lincosamide clindamycin, lincomycin is effective against Streptococcus pyogenes, Streptococcus viridans, Corynebacterium diphtheriae, Propionibacterium acnes, Clostridium perfringens, and Clostridium tetani. It acts against some species of mycoplasma, actinomycetes, and plasmodium. Lincomycin is not effective against many strains of Enterococcus faecalis. It is also inactive against Hemophilus influenzae, Neisseria gonorrhoeae, Neisseria meningitidis, and other gram-negative bacteria and yeasts. Many safer drugs are now available to provide coverage for the aforementioned organisms, thus the use of lincomycin is reserved for serious infections that are resistant to other drugs, or for people who have serious antibiotic allergies to penicillin.
Lincomycin is effective against serious anaerobic infections, and it can be administered orally, intramuscularly, intravenously, topically, or subconjunctivally. The oral form is best taken on an empty stomach one to two hours prior to meals, because food diminishes the rate and extent of absorption. It does, however, cause gastrointestinal symptoms like nausea, vomiting, and diarrhea. Some people experience headache, dizziness, cramps, and sore mouth. These symptoms are expected to disappear as the body adapts to lincomycin, but persistent and increasing severity of symptoms should prompt a consultation with a doctor.
All forms of lincomycin can cause reactions like urticaria, dermatitis, erythema multiforme, and itching of the anal region. The feared adverse reactions to this drug include non-production of white blood cells known as agranulocytosis, aplastic anemia, and a generalized drop in the numbers of all blood cells, known as pancytopenia. Anaphylaxis, hypotension, and pseudomembranous colitis are also very serious adverse reactions that warrant discontinuation of the use of the drug.
People with liver or kidney disease should take precaution when using this drug. The explanation behind this is that both bile and urine are important means of excretion of this drug. With renal or hepatic impairment, this drug stays longer in the blood and may cause toxicity. Unfortunately, when there is an overdosing of this drug it cannot be effectively removed from the blood by either hemodialysis or peritoneal dialysis. Doctors usually reduce the dose by as much as 25 to 30% in people with either liver or kidney disease in order to prevent toxicity.
