린코마이신
**린코마이신(Lincomycin)**은 클린다마이신과 밀접한 관련이 있는 좁은~중간 스펙트럼의 **린코사마이드계 항생제**입니다. 수의학에서는 주로 감수성이 있는 그람 양성 호기성 구균(포도상구균 및 연쇄상구균 등), 다양한 혐기성 세균 및 마이코플라스마에 의한 감염을 치료하는 데 사용됩니다. 주요 약리학적 특징은 다음과 같습니다: - **항균 스펙트럼**: 많은 혐기성 세균, 그람 양성 호기성 세균 및 톡소플라스마에 효과적입니다. 일반적으로 그람 음성 호기성 세균 및 장구균(Enterococcus faecalis)에는 효과가 없습니다. - **임상적 유용성**: 개, 고양이, 돼지에서의 사용이 FDA 승인을 받았으나, 소동물에서는 경구 생체이용률이 더 좋고 내재적 활성이 높으며 독성이 낮은 클린다마이신으로 대체되는 추세입니다. - **독성 특징**: 후장 발효 동물 및 반추동물(예: 말, 토끼, 설치류)에는 심각하고 치명적인 클로스트리듐성 장염을 유발할 위험이 있으므로 **절대 금기**입니다. > **임상 팁**: 린코마이신은 시간 의존성 항생제입니다. 투여 간격 동안 약물 농도를 최소억제농도(MIC) 이상으로 유지하는 것이 임상적 성공에 매우 중요합니다.
작용 기전: Lincomycin exerts its antibacterial effects by binding to the **50S ribosomal subunit** of susceptible bacteria. **Mechanism Pathway**: Drug enters bacterial cell → Binds reversibly to the **50S ribosomal subunit** → Blocks the transpeptidation and translocation steps → **Inhibits bacterial protein synthesis**. Depending on the concentration of the drug at the infection site and the specific susceptibility of the targeted organism, lincomycin can be either **bacteriostatic** or **bactericidal**. > **Note**: Complete cross-resistance occurs between lincomycin and clindamycin, and partial cross-resistance occurs with macrolides like erythromycin due to overlapping ribosomal binding sites.
동물 종별 용량
- Skin and soft tissue infections · 11 mg/kg IM q12h or 22 mg/kg IM q24h · IM · q12h or q24h · 12 days or less
- Systemic infections · 15 mg/kg PO q8h or 22 mg/kg PO q12h · PO · q8h or q12h · 12 days or less
- Susceptible bacterial infections · 22 mg/kg · IM · q24h
- Susceptible bacterial infections · 11 mg/kg · IM · q12h
- Susceptible bacterial infections · 11-22 mg/kg · IV · q12-24h · Must be administered slowly
- Susceptible bacterial infections · 22 mg/kg · PO · q12h
- Susceptible bacterial infections · 15 mg/kg · PO · q8h
- Mycoplasmal (M. hyopneumoniae) pneumonia · Fed at 200 grams per ton of feed for 21 days or 11 mg/kg IM once daily · PO, IM · Continuous in feed or once daily IM · 21 days (feed)
- Susceptible infections · 11 mg/kg IM once daily for 3-7 days; or added to drinking water at a rate of 250 mg/gallon (average of 8.36 mg/kg/day) · IM, PO · Once daily (IM) or continuous in water · 3-7 days (IM)
- Susceptible infections · 10-15 mg/kg PO three times daily; 10 mg/kg IM twice daily · PO, IM · Three times daily (PO) or twice daily (IM)
투여 경로
금기
- Rabbits
- Hamsters
- Guinea pigs
- Horses
- Ruminants (cattle, sheep, goats)
- Patients with known hypersensitivity to lincosamides
- Patients with preexisting monilial (yeast) infections
- Neonatal animals (relative contraindication due to gut flora effects)
- Rapid intravenous administration
- Known hypersensitivity to lincosamides
- Use with caution in patients with severe liver disease
이상반응
- Gastroenteritis (emesis, loose stools, bloody diarrhea in dogs)
- Pain and inflammation at IM injection sites
- Hypotension and cardiopulmonary arrest (if administered rapidly IV)
- Gastrointestinal disturbances in swine
- Diarrhea in nursing neonates (drug distributes into milk)
- Diarrhoea (potentially haemorrhagic)
- Colitis
- Hepatotoxicity (in patients with pre-existing liver disease)
- Cardiac depression (if given rapidly IV)
- Peripheral neuromuscular blockade (if given rapidly IV)
약물 상호작용
- Cyclosporine · Lincomycin may reduce systemic levels of cyclosporine.
- Erythromycin · In vitro antagonism occurs due to competing ribosomal binding sites; concomitant use should be avoided.
- Kaolin · Reduces the absorption of oral lincomycin by up to 90%. If both are necessary, separate doses by at least 2 hours. · moderate
- Neuromuscular blocking agents (e.g., pancuronium) · Lincomycin possesses intrinsic neuromuscular blocking activity and may enhance the effects of these agents; use cautiously.
- Neuromuscular blocking agents · Enhanced neuromuscular blockade action · major
- Chloramphenicol · Antagonistic antimicrobial action (competes for 50S ribosomal binding site) · major
- Macrolides · Antagonistic antimicrobial action (competes for 50S ribosomal binding site) · major
모니터링
- Clinical efficacy (resolution of infection)
- Adverse effects, particularly severe or bloody diarrhea
- Liver function tests (AST, ALT, Alk. Phosph.) may show slight, usually clinically insignificant, increases
- Fecal consistency (monitor for diarrhoea or haemorrhagic stool)
- Liver enzymes (in patients with pre-existing hepatic impairment)
과용량
There is limited information regarding acute overdoses. Lincomycin appears to have a wide margin of safety in dogs. Oral doses up to 300 mg/kg/day for up to one year, or parenteral doses of 60 mg/kg/day, did not result in apparent toxicity. If a massive overdose occurs, standard supportive care and gastrointestinal decontamination (if oral and recent) should be considered.
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