The use of lincomycin is avoided because there is a significant occurrence of
pseudomembranous colitis. Clindamycin is the drug of choice because it is safer
and more effective than lincomycin.
Patient assessment before administering lincosamides is the same as for all
antibiotics. In addition, determine if the patient has a history of GI diseases, liver
or kidney problems.
Administer lincosamides with a full glass of water or with meals to prevent
esophageal ulceration. After lincosamides are administered, request additional
white blood count studies to determine the effectiveness of the medication.
Monitor the patient for:
- Abdominal cramps.
- Diarrhea.
- Weight loss.
- Weakness.
The patient should be provided with the same instructions as is given to a
patient who is receiving penicillin (see Penicillin and Patient Education).
Clindamycins and Drug-Drug Interactions
Besides being associated with pseudomembranous colitis, clindamycin can also
cause an adverse interaction with antidiarrheals, chloramphenicol (Chloromycetin),
and erythromycin.
Clindamycin is known to enhance the neuromuscular blockage caused by
anesthetic agents. This might result in the patient experiencing skeletal muscle
weakness, respiratory depression, and even paralysis if used during or immedi-
ately after surgery.
Lincosamides, Nursing Diagnosis,
and Collaborative Problems
Patients who receive clindamycin may also experience hypersensitivity.
Therefore, you must be prepared to identify the signs and symptoms of hyper-
sensitivity and treat them if conditions become intolerable for the patient.
CHAPTER 13 Antimicrobials—Fighting Infection^225