SLIDE SHOW
Macrolides: A
Quick Overview
MEDIHELP APP
INTRODUCTION
Macrolides are a class of
antibiotics characterized by a
macrocyclic lactone ring structure.
They're derived from various
natural sources, predominantly
from soil-dwelling bacteria and
some fungi.
Isolated form sterptomyces
species. The lead compound is
Erythromycin
MOA
Macrolides bind to bacterial ribosomes, specifically the 50S
subunit, inhibiting protein synthesis by blocking peptide bond
formation. This disruption halts bacterial growth by preventing
the elongation of protein chains, exerting a bacteriostatic
effect.
Maybe bactericidal at higher doses.
Safe to human --> selective chemotherapy
Macrolides Erythromycin Azithromycin
Main Treats respiratory
tract infections, skin
Often prescribed for
respiratory infections,
such as bronchitis and
Members
infections, and pneumonia, as well as
certain sexually skin infections and
transmitted sexually transmitted
diseases. diseases.
Clarithromycin
Treats respiratory
infections, skin
infections, and
certain bacterial
stomach ulcers.
ERYTHROMYCIN INDICATIONS
Available in various forms—oral,
topical, and intravenous.
Respiratory Infections:
Pneumonia & Bronchitis
Skin Infections: Acne &
Cellulitis.
STDs: Chlamydia & Gonorrhea.
Conjunctivitis
Digestive System Infections:
Gastrointestinal Infections
ERYTHROMYCIN
GENERAL DOSING RECOMMENDATIONS (ADULTS)
250 mg PO q6hr, OR
500 mg PO q12hr (if daily dose does not exceed 1 g)
May increase up to 4 g/day depending on infection severity
GENERAL DOSING RECOMMENDATIONS
(CHILDREN)
Mild-to-moderate infections: 30-50 mg/kg/day PO divided q6-8hr
Severe infection: 60-100 mg/kg/day PO divided q6-8hr
Not to exceed 4 g/day
ERYTHROMYCIN
CONTRAINDICATED PREGNANCY BREASTFEEDING
Coadministration with Category B: May be Distributed in breast
HMG-CoA reductase acceptable. milk, use with
inhibitors that are caution; AAP
extensively categorizes as
metabolized by compatible with
CYP3A4 (lovastatin or breastfeeding
simvastatin)
AZITHROMYCIN INDICATIONS
Typically available as tablets or
suspension.
Respiratory Infections:
Pneumonia, Sinusitis &
Bronchitis.
Skin Infections: Impetigo &
Cellulitis.
STDs: Chlamydia & Gonorrhea.
Conjunctivitis.
Ear Infections: Otitis Media.
AZITHROMYCIN
GENERAL DOSING RECOMMENDATIONS (ADULTS)
For most infections, the typical dose is 500 mg on the first day followed
by 250 mg once daily for 4 more days.
- For more severe infections, higher doses may be prescribed.
- For sexually transmitted diseases such as chlamydia, a single dose of 1
gram (1000 mg) may be given.
GENERAL DOSING RECOMMENDATIONS
(CHILDREN)
The typical dose for ear infections, pneumonia, throat infections, or
sinusitis is 10 mg/kg of body weight on the first day, followed by 5
mg/kg once daily for 4 more days.
- For more severe infections, the dose may be higher, and the duration
of treatment may be longer.
AZITHROMYCIN
CONTRAINDICATED PREGNANCY BREASTFEEDING
Azithromycin is Azithromycin is excreted
History of cholestatic in breast milk in small
categorized as a
jaundice/hepatic quantities. However, it is
Category B drug by
dysfunction associated considered to be
the U.S. Food and compatible with
with prior use of
Drug Administration breastfeeding by the
azithromycin
(FDA), AAP
CLARITHROMYCIN
INDICATIONS
Available in tablet form and as a
suspension.
Respiratory Infections: Pneumonia,
Sinusitis & Bronchitis.
Skin Infections: Impetigo &
Cellulitis.
STDs: Chlamydia & Gonorrhea.
Conjunctivitis.
Helicobacter pylori Infection.
Mycobacterial Infection
CLARITHROMYCIN
GENERAL DOSING RECOMMENDATIONS (ADULTS)
For most infections, the typical dose is 250 mg to 500 mg taken every 12
hours for 7 to 14 days.
For more severe infections, such as mycobacterial infections, the dose
may be higher, and the duration of treatment may be longer.
GENERAL DOSING RECOMMENDATIONS
(CHILDREN)
The typical pediatric dose for mild to moderate infections is 7.5 mg/kg
up to 500 mg every 12 hours for 10 days.
The dosing may be different for more severe infections or for specific
conditions.
CLARITHROMYCIN
CONTRAINDICATED PREGNANCY BREASTFEEDING
Coadministration with Clarithromycin is APP Classified it as a
HMG-CoA reductase drug “For which the
categorized as a
inhibitors (statins) that are
extensively metabolized by Category C drug by effect on nursing
CYP3A4 (lovastatin, the U.S. Food and infants is unknown
simvastatin), due to the Drug Administration but may be of
increased risk of myopathy, (FDA)
including rhabdomyolysis concern.”
DIRITHROMYCIN
Uses: Used to treat respiratory tract infections
like pneumonia and bronchitis.
Administration: Typically available in tablet form.
Considerations: Generally well-tolerated but
may cause mild side effects like gastrointestinal
upset.
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