Analogues of the drug lincomycin, indications for their use

"Levomekol" is an antibacterial combination drug for external use with a wide spectrum of action. Levomekol ointment prevents the spread of pathogenic microbes, eliminates swelling, accelerates wound healing, and also increases local skin immunity.

Levomekol for burns

This combination is provided by two active components in the ointment - Chloramphenicol (aka Levomycetin) and Methyluracil. Chloramphenicol is a natural antibiotic that actively blocks intestinal, pseudomonas and staphylococcal bacilli. And methyluracil accelerates the regeneration of the epidermis. The peculiarity of methyluracil is its ability to easily and quickly penetrate into the dermis, without affecting the membrane cell membrane. This process is associated with the removal of excess fluid from the intercellular space, which usually causes swelling and bruising.

What is Levomekol used for?

Levomekol has a multifaceted therapeutic effect:

• quickly reduces the inflammatory process, prevents its spread to healthy tissues;
• prevents the growth and reproduction of bacterial infectious agents;
• quickly eliminates swelling by normalizing microcirculation;
• ensures delivery of nutrients and biologically active substances, as well as molecular oxygen, to the affected tissues;
• stimulates the regeneration of inflammatory cells of all layers of the epidermis;
• increases immunity at the local level.

The ointment quickly removes all inflammatory processes on the skin

It is worth noting that the presence of purulent discharge and necrotic tissue does not prevent Levomekol ointment from performing its function. The drug can be used to disinfect and accelerate tissue regeneration.

Indications for use of Levomekol ointment

Since Levomekol ointment has an antibacterial effect, and at the same time stimulates the restoration of tissue structure, the drug is indicated for the following diseases:

• infection of wounds with pathogenic microflora, ulcers and purulent abscesses on the epidermis;
• burns (mostly 2nd and 3rd degree);
• violation of tissue integrity due to injuries;
• necrotic processes;
• weeping and dry eczema;
• calluses;
• trophic ulcers;
• frostbite of the extremities (superficial layers of the skin);
• pimples, acne, carbuncles, boils;
• otitis and sinusitis (including with purulent discharge);
• treatment of sutures after surgery
• bedsores;
• haemorrhoids.

Levomekol ointment can be used for children

"Levomekol" can be used for children from 1 year. But before this, it is imperative to consult a pediatrician.

Lincomycin capsules - dosage regimen, reviews

Lincomycin for oral administration is available in 250 mg capsules and is a prescription drug that should only be used as directed by a doctor. The regimen for use in children over 12 years of age and adults is 2 capsules 3-4 times a day (the duration of administration is determined by the doctor, but usually from 5 to 7 days). In younger children and pregnant and lactating women, taking the drug is prohibited.

The drug should be taken only on an empty stomach - approximately 1-1.5 hours before meals (below we will tell you what this is connected with). And this may be inconvenient, but according to the instructions - you should only take Lincomycin capsules with a full glass of water! Failure to comply with this rule will affect the effectiveness, as well as the already low safety of the drug.

Contents of one capsule of Lincomycin:

→ Lincomycin: official instructions for use (download in PDF)

Reviews of lincomycin capsules:

Most modern antibiotics have high bioavailability (absorbed from the intestines quickly and completely), which, for example, allows them to be taken after meals. Taking lincomycin capsules 1.5 hours before meals is associated with low bioavailability of the drug - even when taken on an empty stomach, no more than 30% of the active substance is absorbed from the intestines. At the same time, simultaneous food intake reduces the absorption of lincomycin in the intestine - only up to 5% of the active substance.

Those. simultaneous ingestion of food reduces the effectiveness of lincomycin by 4-5 times, and at the same time, the antibiotic that is not absorbed from the intestine continues to kill all beneficial microflora in the intestine. Poor bioavailability of lincomycin and the inability to combine its intake with food often cause the development of antibiotic-dependent diarrhea in patients. Therefore, a drug such as Lincomycin capsules should be taken only in parallel with taking probiotics.

How effective is Lincomycin as an antibiotic?

Scientific studies show that lincomycin shows good effectiveness only in 36.8% of cases, while in 63.2% of cases, pathogenic bacteria at the site of inflammation have only weak sensitivity to lincomycin. But if you have long-term inflammation (and especially if you have already taken courses of Lincomycin in the past), the effectiveness will be worse.

The same study showed that when it comes to long-term foci of inflammation in the area of ​​tooth roots (for example, in the presence of a fistula, granuloma/cyst), lincomycin will be effective only in 19% of cases. At the same time, in 47.6% of cases, Lincomycin demonstrates only weak effectiveness, and in the remaining 33.4% of cases, patients have complete resistance of the microflora in the inflammation site to lincomycin (it forms especially quickly in staphylococci).

Taking probiotics with Lincomycin:

Antibiotics of the lincosamide group are very often the cause of antibiotic-dependent diarrhea. If you have previously experienced diarrhea while taking antibiotics, or you have dysbiosis or other gastrointestinal diseases, in this case we do not recommend that you take antibiotics such as Lincomycin or Clindamycin. To reduce the risk of diarrhea, as well as reduce the negative impact of the antibiotic on the intestinal microflora, parallel intake of probiotics will help (these drugs contain bacteria beneficial to the intestines). For example, these could be Linex or Bifiform - they are the best, but also the most expensive. However, even simpler probiotics will provide benefits.

Probiotic Bifiform (30 capsules) –

Summary: all this makes the prescription of lincomycin acceptable, for example, when opening a purulent abscess on the gum (flux), as well as when removing a tooth with a purulent granuloma at the root apex. Acceptable simply because in these cases we drain the purulent focus and allow the outflow of pus, and antibiotic therapy in these situations is of secondary importance. But the prescription of lincomycin in the process of treating an exacerbation of chronic periodontitis, or to simply suppress inflammation - all this is ineffective and harmful.

Contraindications

Like many drugs, Levomekol has contraindications:

• individual intolerance to the components of the medication;
• hypersensitivity of the body;
• fungal infections of the epidermis;
• tendency to allergic reactions;
• psoriasis.

The official instructions for use indicate that in pediatrics the ointment is prescribed starting from 3 years of age. However, many pediatricians, based on the harmlessness of Levomekol, allow its use from infancy.

Characteristics of lincomycin

The spectrum of action of lincomycin is quite specific - it acts predominantly on gram-positive flora (staphylococci, pneumococci, some protozoa, streptococci, peptococci, fusobacteria and bacteroides).

There are both oral and enteral forms of the drug. After administration, high concentrations of the drug are created in the biliary tract, bone tissue and inflamed tissues. The antibiotic practically does not pass through the blood-brain barrier. The therapeutic concentration of the drug is maintained for 6 hours after taking a dose of lincomycin. The drug is not metabolized in the body and is excreted primarily by the kidneys, and partly through bile.

Today, the range of sensitivity to the drug allows it to be used in dentistry. This is also helped by the ability of lincomycin to accumulate in inflamed tissues of the oral cavity.

The second feature of the antibiotic is that it accumulates in bone tissue, which allows it to be used in purulent surgery in combination with tetracyclines for the treatment of acute and chronic osteomyelitis.

Lincomycin is also used to treat bacterial pathologies of the lower respiratory tract (pneumonia with pleurisy, abscess, lung destruction), soft tissues (cellulitis, erysipelas), as well as some forms of sepsis.

Among the contraindications for prescribing lincomycin, it is necessary to highlight impaired liver and kidney function, individual hypersensitivity to the drug, as well as pregnancy and lactation. The antibiotic is also not recommended for use in children under one year of age.

Side effects when prescribing lincomycin include allergic reactions, dyspeptic disorders, the addition of secondary bacterial or fungal infections, toxic effects on the liver, inhibition of hematopoiesis, headache, dizziness, local phlebitis with intravenous administration and the development of a sterile abscess.

But there are situations when taking this antibiotic is impossible. Then it is not lincomycin that is used: analogues.

Side effects

Levomekol is considered a universal drug and is usually well tolerated by patients. But in case of overdose (if the drug is used for more than a week), allergic skin reactions may occur.

• hyperemia;
• burning;
• itching;
• urticaria;
• dermatitis at the site of application;
• local swelling;
• When using vaginal tampons, candidiasis may occur.

No incompatibility with other medicinal products has been reported. Make sure that the ointment does not get into your eyes, mucous membranes or inside. In case of contact with eyes and mucous membranes, rinse them immediately with running water. If swallowed, the stomach must be rinsed.

Levomekol in the treatment of burns

For burns, Levomekol is needed to prevent infection of the wound surface with pathogenic infections, as well as to accelerate tissue healing. Levomekol also copes with inflammation, which can lead to suppuration of the wound. The ointment cleanses the affected area well from both purulent discharge and necrotic cells.

The treatment system for a small area burn of 1-2 degrees is as follows:

• before applying the ointment, the wound is washed under running water;
• the ointment is applied to a sterile gauze pad, which is applied to the wound surface;
• the bandage is applied for a day;
• dressings are done every day - up to 5 times a day.

The burn is treated until the tissue is completely healed. The total duration of the course for minor household burns is 5 – 14 days.

Lincomycin ointment - application regimen

Lincomycin-AKOS ointment is produced pharmaceutically in Kurgan (Russia). The ointment is for external use only. The tube weighs 15 g. The indication for use is purulent inflammation of the skin and soft tissues, for example: pyoderma, phlegmon, furunculosis, erysipelas.

Scheme of use - lincomycin ointment - instructions for use recommends applying a thin layer to the affected areas of the skin 2-3 times a day. If there is no improvement within the first few days of use, it can be assumed that the infection is insensitive to lincosamides. In this case, you must urgently consult a doctor to replace the drug with another antibiotic.

Composition of the drug (per 100 g) –

Content of active substances – → content of lincomycin hydrochloride (in terms of lincomycin) – 2.0 g, which corresponds to a concentration of 2%.

Auxiliary ingredients – zinc oxide, solid petroleum paraffin, potato starch, medical vaseline.

→ Lincomycin ointment: official instructions (download in PDF)

Levomekol in the treatment of acne

"Levomekol" has an antibacterial and wound-healing effect, therefore it is widely used in dermatology, in particular, in the treatment of acne. The course of treatment depends on the severity of the disease and the number of skin rashes.

Small pimples are treated by applying a thin layer of ointment to the affected area. This is done in the evening for several hours, and before bedtime Levomekol is washed off. Within two weeks, pimples disappear, facial skin becomes even, and small scars heal.

Treating acne with ointment

Levomekol is applied to isolated inflamed pimples in a thin layer, covered with a small piece of cotton wool and left for 2-3 hours. Therapy lasts 2-3 days.

As for opened pimples, the medicine is placed directly into the resulting holes.

To treat acne, Levomekol is applied to the affected area overnight. In the morning, the ointment must be washed off. Typically, the course of treatment takes 2 weeks, during which the inflammation subsides and the acne breaks out or resolves.

To eliminate subcutaneous acne, you need to do the following:

• after washing with soap, the skin is cleansed with any tonic or lotion;
• Apply the ointment in a thin layer on a sterile napkin and apply it to the area of ​​skin with acne;
• the bandage is fixed with adhesive tape.

The duration of the treatment procedure is 3-5 hours. If deep, painful ulcers appear on the skin, keep the bandage on the body all night.

The duration of therapy is about 7-10 days, depending on the degree of damage to the dermis.

Lincomycin - price, release forms

The antibiotic lincomycin has 3 release forms (capsules, ampoules and ointment), but in any case you will find this drug in pharmacies only from a Russian or Belarusian manufacturer. Moreover, not only Lincomycin is available by prescription in capsules or ampoules, but even in ointment forms. The cost of all drugs is lower - indicated for 2021.

• Lincomycin capsules - each capsule contains 250 mg of the active substance “lincomycin”. For Lincomycin capsules, the price starts from 75 rubles (the package contains 2 blisters of 10 capsules each). If we take into account the standard regimen of use for an adult, 1 package is only enough for 3 days of use, which makes this drug even more expensive than the antibiotic Tsiprolet (from the group of fluoroquinolones).

• Lincomycin in ampoules - each package contains 10 ampoules of 1.0 ml. Each ampoule contains 300 mg of lincomycin hydrochloride, which in percentage terms is a 30% concentration. If we take into account the standard dosage regimen for adults, 1 package is enough for only 2.5 days of antibiotic therapy. The cost of 1 package will be from 90 to 130 rubles (for a short 5-day course of treatment, 2 packages will be required).

• Lincomycin ointment 2% - intended for external use only, used for purulent inflammation of the skin. The ointment is available in tubes of 15 g - with a concentration of the active substance of 2%. The ointment is produced in Kurgan, and its cost will be from 150 rubles.

Levomekol in the treatment of hemorrhoids

Levomekol ointment can be used as an addition to complex therapy for hemorrhoids during periods of exacerbation. It is recommended to use the ointment in cases where blood is released from the hemorrhoids. Since the drug has an antibacterial effect (wounds can be infected with feces), helps relieve inflammation and neutralize pathogenic bacteria, Levomekol is prescribed for the regeneration of anal tissue.

• it is necessary to wash the perineum and anus with soap and water and dry with a soft towel;
• apply a thin layer of ointment to the anus before going to bed;
• the area of ​​influence from above is covered with a bandage and fixed with an adhesive plaster;
• When treating internal nodes, a tampon is soaked in ointment, which is then inserted into the anus.

Levomekol for hemorrhoids

The duration of therapy is 10 days. Since Levomekol is not a specialized antihemorrhoidal drug, after the inflammation has resolved, the decision to continue therapy and prescribe medications is made only by the attending physician.

Levomekol in the treatment of wounds

Levomekol helps heal damaged tissue and prevents infection of the wound surface. Moreover, it is not so important whether the wound has festered or not. If the wound is not purulent, then first the affected area is treated with an antiseptic. The ointment is applied in a thin layer overnight, then it must be covered with a sterile gauze cloth and secured with a bandage. Most often, wound treatment is required once a day.

If the wound festers, then using cotton-gauze swabs moistened with an antiseptic, the pus and secreted secretions are removed. Then Levomekol ointment is applied to the wound - it should be completely filled, but not too tightly. The affected area is covered with a gauze cloth, also soaked in ointment. As for the frequency of changing the bandage, it all depends on the amount of pus released. Usually a double dressing is sufficient.

And if the wound is deep and accompanied by an infectious lesion, then Levomekol is preheated to 35 degrees Celsius, then a sterile napkin is soaked in ointment (several can be used if the affected area is large) and injected into the lesion. If the affected area is large, use several napkins with Levomekol. It is important that the wound is filled completely, but not too tightly.

Note that to administer the medication into puncture and deep wounds, it is better to use a rubber drainage tube, and inject the heated ointment itself using a syringe.

The duration of therapy usually lasts from 5 to 10 days.

Lincomycin injections - instructions

Each package of Lincomycin for injection contains 10 ampoules of 1 ml. Each ampoule contains 300 mg of the active substance (lincomycin hydrochloride), which corresponds to its concentration of 30%. Lincomycin solution in ampoules - can be used from almost one month of age, i.e. practically no age restrictions.

However, this is due not so much to the safety of the drug - but to the fact that it is used in purulent surgery mainly for the treatment of septic conditions caused by staphylococcus and streptococcus, pneumonia, purulent infections of the skin and soft tissues, i.e. in such conditions when safety for children's health is a secondary factor.

Single dosage of Lincomycin for an adult (2 amps of 1 ml) –

Dosage regimen for IM administration - usually for adults and children over 14 years of age with intramuscular injections into the buttock - a single dose is 600 mg, i.e. You need to take 2 ampoules of the drug into the syringe at once. Usually injections are given 2 times a day (morning and evening, with an interval of 12 hours). In severe cases, injections are given 3 times a day - with intervals of 8 hours between them. For children aged 1 month to 14 years, the daily dose is calculated according to the following scheme: 10-20 mg per 1 kg of body weight per day.

Features of use: when administered intramuscularly, it is necessary to inject the drug deep into the soft tissues. This is necessary in order to avoid the appearance of compaction in the injection area, as well as the development of purulent soft tissue abscess. Lincomycin is administered intravenously only by drip, at a rate of approximately 60-80 drops per minute. Before intravenous administration, 2 ml of a 30% solution of Lincomycin must be diluted in 250 ml of isotonic sodium chloride solution.

→ Lincomycin hydrochloride in ampoules: official instructions (download in PDF)

Use of Levomekol ointment in gynecology

Levomekol is successfully used in gynecology and urology.

In gynecology, therapy is carried out using tampons with ointment applied to them. A similar method is indicated for the treatment of the following conditions:

• inflammatory erosion of the cervix;
• inflammation of the uterine appendages (ovaries, fallopian tubes);
• divergence of vaginal sutures after ruptures during childbirth or operations.

The treatment system consists of the following sequence of actions:

• before use, a woman must thoroughly wash and dry the skin of the treatment area and perineum;
• if therapy is used after the divergence of vaginal sutures or after operations, then the sutures must be treated with a weak solution of potassium permanganate or furatsilin;
• you need to make a small cotton swab, put an ointment on top of it measuring 15 mm x 15 mm, and 5 mm high;
• insert into the vagina at night and remove in the morning;
• if therapy is used after the divergence of vaginal sutures or after operations, then the ointment is applied to a gauze bandage and applied to the sutures. Then put on clean underwear (if necessary, you can additionally use a pad). The dressing remains on for 2 to 6 hours.

Using the method described above, the active substance of the ointment is delivered to the affected area and absorbed into the surrounding vaginal tissue.

In urology, Levomekol is used in the treatment of balanitis and balanoposthitis in men, as it has anti-inflammatory and antimicrobial effects. The treatment system consists of the following sequence of actions:

• before applying the ointment, the head of the penis is washed with a weak solution of potassium permanganate or furatsilin, removing pus and dead tissue;
• Levomekol is applied to the affected area in a dense layer.

The remedy is applied 1-2 times a day until complete recovery. After the inflammation is relieved, Levomekol is applied for another week, 1 time per day - in the evening, before bedtime.

Lincomycin in dentistry –

The use of Lincomycin in dentistry was initially justified by the fact that this antibiotic has an affinity for bone tissue.
This means that it accumulates in higher concentrations in bone tissue than in other tissues. But I learned that this is not entirely true only after working as a dentist for 10 years, and until that moment we were never given information that lincomycin is unevenly distributed throughout the bone mass (24stoma.ru). It turns out that its increased concentration is created mainly only in the bones of the small pelvis, and not at all in the jaws. Lincomycin capsules used to be one of the most prescribed antibiotics in dentistry, although I am sure that it is still actively prescribed in remote regions of Russia. The usual regimen of use is 2 capsules 3 times a day (for 5-7 days). The following situations can be considered the most optimal indications for the use of this antibiotic in dentistry:

• if a tooth is removed due to purulent inflammation,
• to prevent complications after complex tooth extraction or tooth root resection,
• after opening the flux on the gum (Fig. 1),
• with the development of inflammation of the socket of the extracted tooth (Fig. 2).

Abscess on the gum and inflammation of the socket: photo

It should be noted that in case of a serious purulent infection, Lincomycin, of course, should not be prescribed (otherwise, in any case, it must be combined with other antibiotics, for example, fluoroquinolones). But why do this if you can immediately prescribe an effective broad-spectrum antibiotic - the same antibiotic from the fluoroquinolone group. Lincomycin also demonstrates low effectiveness in the treatment of inflammatory gum diseases, especially in the aggressive course of chronic periodontitis.

Levomekol or Vishnevsky ointment. What's better?

Let's start with the fact that Vishnevsky ointment and Levomekol, although they are used in similar cases, still have a multidirectional spectrum of action. Thus, Vishnevsky ointment is effective when the wound is in the process of regeneration. Therefore, it cannot be used when the wound is suppurated or severely inflamed. Yes, the drug contains an antiseptic, but its concentration is not enough to provide a bactericidal effect. Moreover, tar and castor oil stimulate blood circulation in the affected area, which worsens the situation.

This is why Vishnevsky’s ointment is not as effective, since Levomekol has higher antibacterial activity due to the presence of an antibiotic in it and accelerates the process of outflow of pus from the wound. Also important are the following distinctive features that determine the superiority of Levomekol ointment:

• no unpleasant odor;
• higher repair characteristics;
• does not provoke irritation in the treatment area;
• when treating boils, Levomekol quickly initiates an abscess and opening of the abscess, followed by wound healing.

But if Vishnevsky ointment helps the patient, then there is little point in changing it.

Lincomycin analogues

Ceftriaxone

Ceftriaxone is the most common cephalosporin. It is an antibiotic with a wide spectrum of bactericidal effect against gram-positive and gram-negative bacteria. The mechanism of action of the drug is its ability to disrupt the integrity of the cell membrane of microbes, which leads to their lysis.

Unlike lincomycin, ceftriaxone is considered safe for pregnant women and newborns. It is used exclusively in the form for intramuscular or intravenous administration. Among the main indications for prescribing the drug are bacterial pathologies of soft tissues, abdominal cavity, lungs (pneumonia), respiratory tract and digestive system. Ceftriaxone also passes well through the blood-brain barrier, which allows it to be used for meningitis.

The main contraindication for prescribing ceftriaxone is the presence of hypersensitivity to beta-lactam drugs (penicillins, cephalosporins, monobactams, carbapenems).

Also, this drug should not be used if the kidneys have insufficiency and their filtration function is impaired.

Among the side effects of ceftriaxone, it is necessary to highlight allergic reactions of various forms and severity - rash, redness in the injection area, Quincke's edema, anaphylactic shock. Functional disorders of the digestive tract, the addition of a secondary bacterial infection, a transient increase in liver enzymes and headaches with dizziness are also possible.

Doxycycline

Doxycycline is a drug from the tetracyclic series. It is characterized by a bacteriostatic effect - antibiotic molecules pass inside the microbial cell, where they inhibit the ribosomal subunit and stop protein synthesis in it. Doxycycline acts against streptococci, staphylococci, pneumococci, meningococci, gonococci, Shigella, salmonella, enterobacteria and other pathogens.

A feature of doxycycline, like other tetracyclines, is the ability to bind to calcium salts, which significantly increases the specificity of the drug to bone and dental tissue. Its bioavailability for oral administration is about 100%, so this drug is widely used in tablet form.

Doxycycline is prescribed for bacterial inflammation of soft tissues, bones, as well as for a number of specific infectious pathologies (such as typhoid, brucellosis, tularemia, cholera). This antibiotic has also found its use in dentistry.

The following side effects are found with doxycycline:

• hypersensitivity reactions;
• digestive system disorders;
• blurred vision, headache, dizziness, increased intracranial pressure;
• inhibition of hematopoiesis;
• violation of the formation of the skeleton and tooth enamel;
• increased sensitivity to sunlight;
• pain in joints and muscles;
• increased liver enzymes.

The drug is not recommended for use during pregnancy, lactation and in children under 5 years of age.

Contraindications also include porphyria and uncompensated liver diseases.

• Lincomycin - indications for use and contraindications;
• See here - Vancomycin: analogues and instructions for their use;
• Doxycycline - analogues and their brief description: https://med-antibiotiks.com/analogi/analogi-preparata-doksiciklin-svojstva-i-pokazaniya-k-primeneniyu/.

Clarithromycin

Clarithromycin belongs to the macrolide group of antibacterial agents. The drug is capable, like most bacteriostatic drugs, of blocking the 50S ribosomal subunit, which makes it impossible for the microorganism to further reproduce. Clarithromycin molecules are able to accumulate in foci of the inflammatory process, where they can remain for up to 72 hours. This is due to the long potentiating effect of the drug.

Clarithromycin acts against staphylococci, streptococci, Haemophilus influenzae, Listeria, Neisseria, mycobacteria, mycoplasma, chlamydia and toxoplasma. The antibiotic is produced exclusively in tablet form.

Among the indications for prescribing clarithromycin tablets are inflammatory processes of soft tissues, respiratory tracts, ENT organs and the genitourinary system. The antibiotic is produced exclusively in the form of tablets or syrup for children.

Among the side effects, it is necessary to note the addition of a secondary infection, the development of allergic reactions, cases of cardiac tachyarrhythmias, disorders of the digestive system, renal failure, increased liver enzymes in the blood and dizziness.

The main contraindication to the use of clarithromycin is the patient's hypersensitivity to macrolides.

Analogs

Analogs of Levomekol ointment have a bactericidal and healing effect. But the difference lies in the active ingredient of the drug. So, among the analogues one can name Fugentin, Levosin (additionally has an analgesic effect), Protegentin, Fastin-1, Salicylic-zinc paste.

Synonyms, that is, drugs with the same substance (but in higher concentration) as Levomekol ointment, can be considered Netran and Levomethyl. Substitute medications can only be prescribed by the attending physician.