Lincomycin use during pregnancy requires careful evaluation of risk versus benefit. The drug crosses the placenta, and potential fetal harm, including skeletal abnormalities, has been reported. Therefore, lincomycin should be avoided unless clearly needed.
Pregnancy
Only prescribe lincomycin to pregnant patients if the potential benefits significantly outweigh the known risks. Close monitoring of the mother and fetus is vital. Alternative antibiotics should be preferred.
Children
Lincomycin is not usually recommended for children under 1 month old due to potential risks of toxicity. For older children, dosage adjustments based on weight and renal function are necessary. Careful monitoring for side effects, particularly diarrhea, is crucial.
Renal/Hepatic Impairment
Patients with impaired renal function require dose reduction. Lincomycin is primarily excreted through the kidneys; reduced renal function leads to increased plasma levels and heightened risk of toxicity. Dosage should be adjusted based on creatinine clearance. For patients with hepatic impairment, monitor for potential increased adverse effects, as the liver plays a role in lincomycin metabolism, though to a lesser degree than renal excretion. Regular monitoring of liver function tests is advised. Always consult relevant guidelines for precise dosage adjustments.
Specific Monitoring
Regardless of the patient population, monitor for common side effects like diarrhea (which may indicate Clostridium difficile infection), nausea, and vomiting. Serious reactions, though rare, include anaphylaxis. Prompt medical attention is needed should these reactions occur.
