Characterization of the neuromuscular block produced by clindamycin and lincomycin

The site of neuromuscular blockade induced by clindamycin and lincomycin was studied on isolated nerve and nerve–muscle preparations. Clindamycin (3.6 × 10−3 M) but not lincomycin (up to 1.5 × 10−2 M) had a local anaesthetic effect on a frog desheathed nerve preparation. Clindamycin (8 × 10−4 M) and lincomycin (4 × 10−3 M) depressed the response of the rat diaphragm to nerve stimulation and to direct muscle stimulation in parallel. This indicated that the predominant neuromuscular blocking effect of these antibiotics was due to an effect on the muscle. Clindamycin was fivefold more potent than lincomycin in this effect, and the unionized form of both drugs was the active form. Lincomycin (4 × 10−3 M) but not clindamycin (8 × 10−4 M) also had some depressant effect on nerve–muscle transmission as indicated by the interaction of the effects of the antibiotics and d-tubocurarine. The significance of these findings is discussed in relation to the acute clinical toxicity of these antibiotics.