3.5 Lincosamides
Lincosamides essentially comprise of two
clinically useful antibiotics, namely: Lincomycin and Clindamycin; however,
their overall general usage has been restricted and limited on account of their
inherent potentially fatal side effect called pseudomembranous colitis.**
These two aforesaid antibiotics shall now be treated individually
in the sections that follows:
3.5.1 Lincomycin
Synonyms Lincolnensin; Lincolcina;
U-10149; NSC-70731;
Biological Source It is produced by Streptomyces
lincolensis var. lincolensis.
Chemical Structure Lincomycin has an amide
function in its molecule which may have been contributed essentially by an
unique strategic combination of amino acid and carbohydrate metabolites.
It is also obtained through stereoselective synthesis by
the method of Knapp and Kukkola.***
(2S-trans)-Methyl
6, 8-dideoxy-6-[[(1-methyl-4-propyl-2-pyrrodinyl) carbonyl] amino]-1-thio-perythro-α-D-galacto-octopyranoside;
(C18H34N2O6S).
------------------------------------------------
* H. Aoki et
al., J. Antibiot., 29, 492 (1976)
** Pseudomembranous Colitis: Colitis associated with antibiotic therapy. It is indicated by
formation of a
pseudomembrane on the mucosa of the colon. The symptoms are:
diarrhaea, abdominal cramps, fever and leukocytosis
normally after 4 to 10 days after the start of antibiotic
therapy.
*** S. Knapp and P.J. Kukkola, J.
Org. Chem. 55, 1637 (1990).
Characteristic
Features
1. It
is obtained as a free-base invariably.
2. Its
dissociation constant is pKa′ 7.6.
3. It
is found to be more stable in salt form.
4. It
is soluble in methanol, lower alcohols, acetone, ethyl acetate, chloroform; and
slightly soluble in water.
Lincomycin
Hydrochloride Hemihydrate (C18H34N2,
O6S.HCl.½H2O): [Synonyms Frademicina; Lincocin;
Mycivin; Wayenecomycin;]
1. It
was obtained formerly as needle-like crystals of low specific gravity from
aqueous solution by rapid addition of acetone at low temperatures; but nowadays
it is mostly obtained as crystals of relatively higher specific gravity, having
distinct cubic crystal structure with greater solubility in HCl, by the slow
addition of acetone. It has mp 145-147°C.
2. It
has specific optical rotation [α]D25 + 137° (water).
3. It
is found to be freely soluble in water, methanol, ethanol; and sparingly
soluble in most organic solvents other than the hydrocarbons.
Uses
1. It
is active against most Gram-positive bacteria, including pneumococci,
staphylococci, and streptococci, with the exception of Enterococcus faecalis.
2. Its
anaerobic spectra (both Gram-positive and Gram-negative) are also recognized as
significant and distinctive.
3. Its
use is restricted due to its serious side-effects which essentially include:
diarrhoea, occasionally serious pseudomembranous colitis (caused by
overgrowth of resistant strains of Clostridium difficile), which
may cause serious fatalities especially in aged patients.
Note:
Lincomycin inhibits protein biosynthesis due to the blockade of peptidyltransferase
site on the 50S subunit of the bacterial ribosomes 70S.
3.5.2
Clindamycin
Synonyms
Antirobe;
Cleocin; Dalacin C; Klimicin; Sobelin; Clinimycin (rescinded); 7-Deoxy-7(S)-chloro-lincomycin.
Biological
Source Clindamycin (7-chloro-7-deoxy-lincomycin) is
synthetically derived from lincomycin, which is obtained from the
cultures of Streptomyces lincolensis var lincolensis.
Chemical
Structure The semi-synthetic derivative is obtained by the
chlorination of the lincomycin with resultant inversion of
stereochemistry.
(2S-trans)-Methyl
7-chloro-6,7,8-trideoxy-6-[[(1-methyl-4-propyl-2-pyrrolidinyl) carbonyl]
amino]-1-thio-L-threo-a-galacto-octo-pyranoside; (C18H33ClN2O5S).
Characteristic
Features
1. It
is obtained as yellow amorphous solid.
2. It
has specific optical rotation [α]D+ 214° (chloroform).
Clindamycin
Hydrochloride Monohydrate [C18H33ClN2O5S.HCl.H2O]:
[Synonym Dalacin]:
1. It
is obtained as white crystals obtained from a mixture of ethanol-ethyl acetate
having mp 141-143°C.
2. It
has specific optical rotation [α]D+ 144° (H2O).
3. Its
dissociation constant is pKa 7.6.
4. It
is found to be soluble in water, ethanol, DMF, and pyridine.
Uses
1. It
appears slightly more effective quantitatively than its structural analogue
lincomycin.
2. It
is more readily eliminated from the body. The normal 300 mg dose of lincomycin
gives a peak serum level of 2.6 to 3.6 mcg. ml–1 in 1-2 hours, and the normal
half-life ranges between 2-4 hours.
3. Clindamycin
is reported to be one of the most effective antibiotics against strains of
Bacteroides
fragilis, the Gram-negative anaerobe that is responsible for a number
of abdominal infections.
4. The
antianaerobic property of clindamycin renders it useful in pneumonias
caused by anaerobes.
5. Clindamycin
phosphate is employed topically for the treatment, control and management
of serious acne and vaginally for bacterial vaginosis.
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