Contents

Search

macrolide (macrolide antibiotic)

Structure: - a group of macrocyclic compounds formed by chain extension of multiple proprionates & cyclized into a 12-16 membered lactone - often glycosylated Indications: - bacterial infections Contraindications: - use during pregnancy not associated with increased risk of birth defects [4] - use during pregnancy is associated with increased risk of birth defects [5] Adverse effects: - dose-dependent association with tinnitus [6] Mechanism of action: - many are antibacterial agents - many macrolides have anti-inflammatory properties [3]* * macrolide may improve clinical outcome despite antibiotic resistance [3]

Interactions

drug interactions drug adverse effects of macrolide(s)

Specific

azithromycin (Zithromax, Zmax, Z-pak, AzaSite) clarithromycin (Biaxin) dirithromycin (Dynabac) epothilone erythromycin (Eryc, Eryctte, E-mycin, Ilotycin, AK-Mycin, A/T/S, T-stat) fidaxomicin (Dificid) gamithromycin (Zactran) ketolide oleandomycin (Landomycin, Tribocillina) solithromycin (Solitaire) tildipirosin (ZUPREVO) tilmicosin (Micotil) troleandomycin tulathromycin (Ketek, Draxxin) tylosin (Tylan)

General

antibacterial agent

References

  1. NLM MeSH Browser http://www.nlm.nih.gov/mesh/meshhome.html
  2. Kunisaki KM and Niewoehner DE Antibiotic prophylaxis for chronic obstructive pulmonary disease: resurrecting an old idea. Am J Respir Crit Care Med. 2008 Dec 1;178(11):1098-9 PMID: 19023036
  3. Ampel NM Should Macrolides Be Used for Community-Acquired Pneumonia? NEJM Journal Watch. June 16, 2015 Massachusetts Medical Society (subscription needed) http://www.jwatch.org - Cilloniz C et al. The effect of macrolide resistance on the presentation and outcome of patients hospitalized for Streptococcus pneumoniae pneumonia. Am J Respir Crit Care Med 2015 Jun 1; 191:1265. PMID: 25807239 - Niederman MS. Macrolide-resistant pneumococcus in community-acquired pneumonia: Is there still a role for macrolide therapy? Am J Respir Crit Care Med 2015 Jun 1; 191:1216. PMID: 26029831
  4. Berard A et al Use of macrolides during pregnancy and the risk of birth defects: a population-based study. Pharmacoepidemiology and Drug Safety. Oct 29, 2015 PMID: 26513406 http://onlinelibrary.wiley.com/doi/10.1002/pds.3900/abstract;jsessionid=D48B754D181DE5E6CC5507D7E5D0E6FC.f03t01
  5. Fan H, Gilbert R, O'Callaghan F, Li L Associations between macrolide antibiotics prescribing during pregnancy and adverse child outcomes in the UK: population based cohort study. BMJ 2020;368:m331 PMID: 32075790 Free Article https://www.bmj.com/content/368/bmj.m331
  6. Vanoverschelde A, Oosterloo BC, Ly NF et al. Macrolide-associated ototoxicity: A cross-sectional and longitudinal study to assess the association of macrolide use with tinnitus and hearing loss. J Antimicrob Chemother 2021 Jul 27; [e-pub]. PMID: 34312676 https://academic.oup.com/jac/advance-article/doi/10.1093/jac/dkab232/6328751