Unfavorable effect of atropine-diphenoxylate (Lomotil) therapy in lincomycin-caused diarrhea
E. Novak, J. G. Lee, C. E. Seckman, J. P. Phillips and A. R. DiSanto
In this double-blind, randomized study, 200 normal subjects received a
three-day course of one of five treatment regimens: lincomycin
hydrochloride monohydrate injection (sterile solution, 300 mg/ml) with two
tablets of either placebo, a mixture of atropine sulfate and diphenoxylate
hydrochloride (Lomotil), an aspirin-phenacetin-caffeine (APC) combination
or the latter with codeine, or an injection of saline with two placebo
tablets. Gastrointestinal irritation was most prominent in subjects
receiving lincomycin with atropine-diphenoxylate and lincomycin with APC
plus codeine (P less than .05). Decreased intestinal motility from
atropine-diphenoxylate or codeine may increase the contact time between the
lincomycin (or its metabolites) or some developing toxic substances and the
mucosal epithelium. The use of atropine-diphenoxylate or codeine in
treating lincomycin-induced diarrhea may be questionable.
