priate fluid and electrolyte management, protein supplementation, antibacterial treatment of c. difficile, and surgical evaluation should be instituted as clinically indicated. hypersensitivity serious hypersensitivity reactions, including anaphylaxis and erythema multiforme, have been reported with use of lincomycin injection. if an allergic reaction to lincomycin occurs, discontinue the drug. (see adverse reactions ) benzyl alcohol toxicity in pediatric patients ("gasping syndrome") lincomycin injection sterile solution contains benzyl alcohol as a preservative. the preservative benzyl alcohol has been associated with serious adverse events, including the "gasping syndrome", and death in pediatric patients. although normal therapeutic doses of this product ordinarily deliver amounts of benzyl alcohol that are substantially lower than those reported in association with the "gasping syndrome", the minimum amount of benzyl alcohol at which toxicity may occur is not known. the risk of benzyl alcohol toxicity depends on the quantity administered and the liver and kidney's capacity to detoxify the chemical. premature and low-birth weight infants may be more likely to develop toxicity. use in meningitis — although lincomycin appears to diffuse into cerebrospinal fluid, levels of lincomycin in the csf may be inadequate for the treatment of meningitis.

diluted in not less than 100 ml of appropriate solution (see physical compatibilities) and infused over a period of not less than one hour. these doses may be repeated as often as required to the limit of the maximum recommended daily dose of 8 grams of lincomycin. pediatric patients over 1 month of age: 10 to 20 mg/kg/day (5 to 10 mg/lb/day) depending on the severity of the infection may be infused in divided doses as described above for adults. note: severe cardiopulmonary reactions have occurred when this drug has been given at greater than the recommended concentration and rate. subconjunctival injection- 0.25 ml (75 mg) injected subconjunctivally will result in ocular fluid levels of antibacterial (lasting for at least 5 hours) with mics sufficient for most susceptible pathogens. patients with diminished renal function: when therapy with lincomycin is required in individuals with severe impairment of renal function, an appropriate dose is 25 to 30% of that recommended for patients with normally functioning kidneys. image2.jpg

nown: jaundice, liver function test abnormal, transaminases increased renal and urinary disorders not known: renal impairment, oliguria, proteinuria, azotemia ¹no direct relationship of lincocin to renal damage has been established. cardiac disorders not known: cardio-respiratory arrest (see dosage and administration) vascular disorders not known: hypotension (see dosage and administration ), thrombophlebitis² ²event has been reported with intravenous injection. ear and labyrinth disorders not known: vertigo, tinnitus not known: injection site abscess sterile³, injection site induration³, injection site pain³, injection site irritation³ ³reported with intramuscular injection.

normal hepatic function. hemodialysis and peritoneal dialysis are not effective in removing lincomycin from the serum. tissue level concentrations indicate that bile is an important route of excretion. significant concentrations have been demonstrated in the majority of body tissues. although lincomycin appears to diffuse into cerebrospinal fluid (csf), concentrations of lincomycin in the csf appear inadequate for the treatment of meningitis. microbiology: lincomycin has been shown to be active against most strains of the following organisms both in vitro and in clinical infections: (see indications and usage). staphylococcus aureus streptococcus pneumoniae the following in vitro data are available; but their clinical significance is unknown. lincomycin has been shown to be active in vitro against the following microorganisms; however, the safety and efficacy of lincomycin in treating clinical infections due to these organisms have not been established in adequate and well controlled trials. gram-positive bacteria:: corynebacterium diphtheriae streptococcus pyogenes viridans group streptococci anaerobic bacteria: clostridium tetani clostridium perfringens cross resistance has been demonstrated between clindamycin and lincomycin. resistance is most often due to methylation of specific nucleotides in the 23s rna of the 50s ribosomal subunit, which can determine cross resistance to macrolides and streptogramins b (mls phenotype). macrolide-resistant isolates of these organisms should be tested for inducible resistance to lincomycin/clindamycin using the d-zone test or other appropriate method. there are currently no antimicrobial susceptibility testing (ast) interpretive criteria for lincomycin.