Macrolide / Ketolides

• Macrolides antibiotics which include erythromycin, azithromycin, and clarithromycin.
• Macrolides work by binding to the 50S subunit of the ribosome, and block translocation
• Macrolides can be administered perorally + parenterally.
• Macrolides are broad spectrum bacteriostatic medications
• Macrolides are used to treat

  • Mycoplasma pneumoniae
  • Bartonella pertussis - whooping cough
  • Legionella 
• Clarithromycin is used in combination with amoxicillin and omeprazole to treat Helicobacter pylori which causes peptic ulcers.
• Azithromycin is often used to treat sexually transmitted infections like chlamydia and syphilis.
• Resistance against macrolides typically involve developing efflux proteins that actively pump macrolides out of the cell.
• Side effects of macrolides include

  • GIT problems
  • prolonged QT interval
  • hepatotoxicity
• Both erythromycin and clarithromycin can inhibit cytochrome p450.