1. 30s • Aminoglycosides
•Tetracycline Antibiotics
50s •Oxazolidinone
•Peptidyl transferase
•MLS(transpeptidation/translocati
on)
EF-G •steriods

2.  Lincosamide are narrow-spectrum antibiotics which act on
staphylococci,streptococci,pneumococci,
 Nonspore-forming anaerobic flora
peptostreptococcus,peptococcus,fusobacterium,
bacteroides.
 Moderately active against
toxoplasama,P.falciparum,pneumocystis.

3.  Lincosamide exert bacteriostatic action associated with
inhibiting protien synthesis.
 In high concentration lincosamides may exert bactericidal
action.
 Lincosamides prevent bacteria replicating by interfering with
the synthesis of proteins. They bind to the 23s portion of the
50S subunit of bacterial ribosomes and cause premature
dissociation of the peptidyl-tRNA from the
ribosome.Lincosamides do not interfere with protein
synthesis in human cells because our ribosomes are
structurally different from those of bacteria.

4.  Streptococcal tonsillopharyngitis
 Infection of lower respiratory tract
 Skin and soft tissue infections including diabetic foot
 Bone and joint infections
 Intra-abdominal infections
 Pelvic infections
 Toxoplasmosis
 Bacterial vaginosis
 Severe Acne

5.  Clindamycin is a lincosamide antibiotic
 Clindamycin is a semisynthetic antibiotic produced by a 7(S)-
chloro-substitution of 7(R)-hydroxyl group of the parent
compound lincomycin.
 It has primary bacteriostatic action against and a wide range
of anaerobic bacteria

6.  Aerobic gram-positive cocci:staphylococcus aureus and
s.epidermis both pencillin and nono-penicillinase producing
strains,streptococci except E.feacalis
 Anaerobic gram-negative: Bacteroides spacies Fusobacterium
 Anaerobic and microaerophillic gram-positive cocci.
 Clostridia

7.  Clindamycin inhibit protein synthesis by revesibly
binding to 50s subunits of the ribosomal thus
blocking the transpeptidation or translocation
reactions of susceptible organisms resulting to
stunted cell growth.

8.  Biologically inactive clindamycin phosphate is rapidly
converted to active clindamycin.
 By the end of short-term intravenous infusion, peak serum
levels of active clindamycin are reached.
 Biologically inactive clindamycin phosphate disappears
rapidly from the serum, the average elimination half-life is 6
minutes

9.  The serum elimination half-life of active clindamycin is about
3 hours in adults and 2½ hours in pediatric patients.
 Serum levels of clindamycin can be maintained above the in
vitro minimum inhibitory concentrations for most indicated
organisms by administration of clindamycin phosphate every
8 to 12 hours in adults and every 6 to 8 hours in pediatric
patients, or by continuous intravenous infusion.

10.  An equilibrium state is reached by the third dose.
 The elimination half-life of clindamycin is increased slightly in
patients with markedly reduced renal or hepatic function.
 Hemodialysis and peritoneal dialysis are not effective in
removing clindamycin from serum. Dosage schedules need
not be modified in the presence of mild to moderate renal or
hepatic disease.

11. Clindamycin is indicated in the treatment of serious
infections caused by susceptible anaerobic
bacteria,streptococci,pneumococciandstaphylococci.
Clindamycin is used chiefly in the treatment of serious
anaerobic infections.
Bacteroides flagilis or susceptible strains of gram positive
bacteria:
 Lower respiratory tract infections including
bronchitis, pneumonia, emphysema and lung abscess.
 UTI
 Septicemia caused by Staphylococcus aureus, Streptococci
(except Enterococcus faecalis), and susceptible anaerobes.

12. LRTI : Lower respiratory tract infections including
bronchitis, pneumonia, emphysema and lung abscess
Bronchitis is inflammation of the mucous membranes of the bronchi
Pneumonia is an inflammatory condition of the lung—especially affecting
the microscopic air sacs (alveoli)—associated with fever, chest symptoms
Emphysema is a type of chronic obstructive pulmonary disease (COPD)
involving damage to the air sacs (alveoli) in the lungs. As a result, body
does not get the oxygen it needs, hard to catch the breath ,chronic cough
and trouble breathing.
Abscess is a collection of pus(dead neutrophils) that has accumulated in a
cavity formed by the tissue in which the pus resides due to an infectious
process

13. Urinary tract infection (UTI) is a bacterial infection that affects part of
the urinary tract.
 When it affects the lower urinary tract it is known as a simple
cystitis (a bladder infection)
Symptoms from a lower urinary tract include painful urination and
either frequent urination or urge to urinate (or both)
 when it affects the upper urinary tract it is known as
pyelonephritis(a kidney infection).
pyelonephritis include fever and flank pain in addition to the
symptoms of a lower UTI.
 The main causal agent of both types is Escherichia coli, however
other bacteria, viruses or fungus may rarely be the cause.

14. Septicemia caused by Staphylococcus aureus, Streptococci (except
Enterococcus faecalis), and susceptible anaerobes.
Septicemia
Septicemia is bacteria in the blood that often occurs with severe
infections.
Causes
 Septicemia is a serious, life-threatening infection that gets worse
very quickly. It can arise from infections throughout the body,
including infections in the lungs, abdomen, and urinary tract. It
may come before or at the same time as infections of the:
 Bone (osteomyelitis)
 Central nervous system (meningitis)
 Heart (endocarditis)
 Other tissues

15.  The parenteral dose for clindamycin in children is 20 to 40
mg/kg/day divided and given IV or IM every 6 or 8 hours.
 In neonates, the dose should be based on both weight and
age, to allow for a slower elimination.
 In preterm neonates less than 2 kg, a dose of 10 mg/kg/day
should be divided and given every 12 hours.
 In neonates over 2 kg and less than 1 week of age, a dose of
15 mg/kg/day should be divided and given every 8 hours.
 In older neonates, a dose of 20-30 mg/kg/day may be
divided and given every 6 to 8 hours

16.  The recommended adult dose for parenteral clindamycin is
600 to 1,200 mg/day divided and given IV or IM every
12, 8, or 6 hours.
 The maximum concentration for IV administration is 18
mg/mL, and the maximum rate of infusion is 30 mg/min

17. Clindamycin is diluted prior to IV administration.
Dose Diluent time
300mg 50ml 10min
600mg 50ml 20min
900mg 50ml-100ml 30min
1200mg 100ml 40min

18.  The drug is contraindicated in individuals with a
history of hypersensitivity to preparation containing
clindamycin or lincomycin

19.  Gastrointestinal: Abdominal pain, nausea, vomiting and
diarrhea and esophagitis with oral preparations.
 Hypersensitivity Reactions: Maculopapural rash and urticaria
have been observed during drug therapy.
 Liver: Jaundice and abnormalities in liver function tests have
been observed during clindamycin therapy.

20.  Skin and Mucous Membranes: Pruritus, vaginitis and rare
instances of exfoliative dermatitis have been observed during
clindamycin therapy.
 Local Reactions: Pain and abscess have been reported after
intramuscular injection and thrombophlebitis after
intravenous infusion.
Reaction can be minimized or avoided by giving deep
intramuscular injections and avoiding prolonged use of
indwelling intravenous catheters.
 Musculoskeletal: Rare instances of polyarthritis have been
reported.

21.  The safety of use in pregnancy has not been
established.
 Clindamycin has been reported to appear in breast
milk.
 If therapy is prolonged, liver and renal function tests
may be monitored periodically.
 May enhance the action of neuromuscular blocking
agents.
 May counteract the effects of erythromycin.