Lincocin (lincomycin hydrochloride) is a lincosamide antibiotic indicated for the treatment of serious infections caused by susceptible strains of gram-positive bacteria, particularly in patients who cannot use penicillin antibiotics. It functions by inhibiting bacterial protein synthesis, effectively halting the growth and proliferation of pathogenic organisms. This injectable formulation is reserved for severe infections where less potent antimicrobial agents are inappropriate or have proven ineffective, providing a critical therapeutic option under specialist supervision.

Features

• Active Ingredient: Lincomycin hydrochloride
• Drug Class: Lincosamide antibiotic
• Administration: Sterile solution for intramuscular or intravenous injection
• Available Strengths: 300 mg/mL in 2 mL and 10 mL vials
• Mechanism of Action: Binds to the 50S subunit of bacterial ribosomes, inhibiting protein synthesis
• Spectrum of Activity: Primarily effective against gram-positive aerobes and anaerobes, including streptococci, staphylococci, and pneumococci

Benefits

• Provides targeted action against resistant gram-positive organisms where penicillin-class antibiotics are contraindicated or ineffective
• Demonstrates reliable bactericidal activity in serious soft tissue, respiratory, and bone/joint infections
• Offers flexible administration routes (IM/IV) suitable for both hospital and extended care settings
• Maintains efficacy in anaerobic environments, making it valuable for abscesses and deep tissue infections
• Serves as an important alternative for patients with documented beta-lactam allergies
• Delivers predictable pharmacokinetics with good tissue penetration, including bone

Common use

Lincocin is primarily employed in the management of serious infections caused by susceptible strains of streptococci, staphylococci, and pneumococci. Its use is generally restricted to cases where penicillin antibiotics are not suitable due to resistance patterns or patient hypersensitivity. Common clinical applications include severe respiratory tract infections such as pneumonia and empyema, skin and soft tissue infections including cellulitis and abscesses, and septicemia. It also finds application in bone and joint infections, particularly osteomyelitis caused by susceptible organisms. The decision to use Lincocin should be based on culture and susceptibility testing whenever possible, though empiric therapy may be initiated in critical situations while awaiting laboratory results.

Dosage and direction

Adult Dosage:

• Serious infections: 600 mg intramuscularly every 12-24 hours
• More severe infections: 600 mg intravenously every 8-12 hours or by continuous infusion
• Maximum daily dose: 8 grams

Pediatric Dosage (over 1 month):

• 10 mg/kg intramuscularly every 12-24 hours
• 10-20 mg/kg intravenously daily in divided doses every 8-12 hours
• Maximum daily dose: 8 grams

Administration Guidelines: Intramuscular injections should be administered deep into large muscle masses, rotating injection sites to prevent tissue irritation. For intravenous administration, dilute to concentration of 1 gram per 100 mL or more of appropriate diluent (normal saline or dextrose solution) and infuse over at least 1 hour. Rapid intravenous administration may cause hypotension and cardiopulmonary arrest. Dosage adjustment is necessary in patients with severe hepatic impairment. Treatment should generally continue for at least 10 days in streptococcal infections to prevent rheumatic fever or glomerulonephritis.

Precautions

Lincocin should be administered with caution in patients with a history of gastrointestinal disease, particularly colitis. Use with care in patients with severe renal or hepatic impairment, requiring appropriate dosage adjustments and monitoring of organ function. Elderly patients may be more susceptible to gastrointestinal side effects, necessitating close observation. Cases of severe and persistent diarrhea have been reported, which may indicate pseudomembranous colitis requiring immediate evaluation. Monitor patients for signs of superinfection or fungal overgrowth during prolonged therapy. Regular assessment of complete blood count, liver, and renal function is recommended during extended treatment courses. Use during pregnancy only if clearly needed, as animal studies have shown evidence of fetal harm. Lincomycin is excreted in breast milk—consider discontinuing nursing during treatment.

Contraindications

Lincocin is contraindicated in patients with known hypersensitivity to lincomycin, clindamycin, or any component of the formulation. It should not be used in patients with a history of antibiotic-associated colitis, inflammatory bowel disease, or enteritis. Contraindicated for treatment of minor bacterial or viral infections where less toxic alternatives are appropriate. Not recommended for patients with meningeal infections due to poor cerebrospinal fluid penetration. Avoid use in neonates due to immature metabolic pathways and increased risk of toxicity. Concomitant administration with neuromuscular blocking agents is contraindicated due to potential enhancement of neuromuscular blockade.

Possible side effect

Common (≥1%): Gastrointestinal disturbances including nausea, vomiting, abdominal pain, and diarrhea; injection site reactions (pain, induration, sterile abscess); skin rash and pruritus; vaginitis

Less Common (0.1-1%): Elevated liver enzymes; leukopenia; neutropenia; thrombocytopenia; dizziness; headache; hypotension with rapid IV administration; metallic taste

Rare (<0.1%): Pseudomembranous colitis (may be severe); anaphylactoid reactions; angioedema; Stevens-Johnson syndrome; toxic epidermal necrolysis; hepatitis; jaundice; renal dysfunction; polyarthritis; cardiopulmonary arrest with rapid IV infusion; neuromuscular blockade; superinfection including candidiasis

Post-marketing Reports: Severe cutaneous adverse reactions; eosinophilia; tinnitus; vertigo; electrolyte disturbances; prolonged neuromuscular blockade

Drug interaction

Lincocin may potentiate the effects of neuromuscular blocking agents (succinylcholine, tubocurarine), increasing the risk of prolonged respiratory depression—avoid concomitant use. Antagonism may occur with erythromycin and chloramphenicol, potentially reducing antibacterial efficacy. May reduce the effectiveness of oral contraceptives—recommend alternative contraceptive methods during therapy. Kaolin-pectin antidiarrheals may decrease lincomycin absorption. Concurrent use with opioid antidiarrheals may worsen or mask symptoms of colitis. May enhance the effects of warfarin, requiring closer monitoring of coagulation parameters. Cyclosporine levels may increase with concomitant administration. Use with caution with other potentially hepatotoxic or nephrotoxic medications.

Missed dose

If a dose is missed, administer it as soon as possible. However, if it is almost time for the next scheduled dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed administration. Maintaining consistent antibiotic levels is important for therapeutic efficacy, particularly in serious infections. If multiple doses are missed or there is uncertainty about dosing, contact the prescribing healthcare provider for guidance. Document missed doses in the patient’s medication record to ensure proper treatment evaluation.

Overdose

Symptoms of overdose may include exaggerated side effects, particularly severe gastrointestinal symptoms including bloody diarrhea, neuromuscular blockade, and cardiovascular collapse. No specific antidote exists. Management is supportive and symptomatic. Discontinue the medication immediately. Maintain airway patency and provide assisted ventilation if respiratory depression occurs due to neuromuscular blockade. Administer intravenous fluids for hypotension. Hemodialysis is not effective for removing significant amounts of lincomycin. Monitor electrolyte balance and renal function. Severe cases may require intensive care support. Consider administration of cholestyramine or colestipol to bind lincomycin in the gastrointestinal tract if recent oral ingestion, though primarily administered parenterally.

Storage

Store vials at controlled room temperature (20-25°C or 68-77°F), with excursions permitted between 15-30°C (59-86°F). Protect from light and excessive heat. Do not freeze. The solution should be clear and colorless—discard if discolored or containing particulate matter. Following reconstitution or dilution for intravenous infusion, solutions are stable for 24 hours at room temperature or 48 hours under refrigeration. Do not use if precipitation occurs. Keep out of reach of children and pets. Dispose of unused medication according to proper pharmaceutical waste protocols. Do not store in bathroom cabinets where moisture and temperature fluctuations may degrade the product.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Lincocin is a prescription medication that should be used only under the supervision of a qualified healthcare professional. The prescribing physician should be consulted for diagnosis and treatment decisions. Individual patient response may vary, and not all side effects or interactions are listed here. Healthcare providers should reference the complete prescribing information before administration. Patients should not adjust dosage or discontinue medication without medical consultation. The safety and efficacy in children under one month of age have not been established.

Reviews

“Lincocin has been invaluable in our infectious disease practice for managing serious gram-positive infections in penicillin-allergic patients. Its consistent efficacy against resistant staphylococci makes it a reliable option when other agents fail.” - Infectious Disease Specialist, 15 years experience

“As a clinical pharmacist, I appreciate Lincocin’s predictable pharmacokinetics and well-established dosing guidelines. The need for monitoring for gastrointestinal complications is well worth the therapeutic benefit in appropriate patients.” - Hospital Pharmacist

“While effective, Lincocin requires careful patient selection and monitoring. We’ve found it particularly useful in orthopedic infections where bone penetration is crucial. The IV administration protocol demands strict adherence to avoid complications.” - Orthopedic Surgeon

“After managing several cases of pseudomembranous colitis associated with lincosamide use, I emphasize the importance of patient education about diarrhea symptoms. However, when used appropriately, it remains a powerful tool against resistant organisms.” - Gastroenterologist