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Macrolides

QuestionAnswer
1.Macrolides Bacteriostatic and ahows time dependant killing
Examples Erythromycin , Clarithromycin, Azithromycin
Mechanism of action Inhibit protein synthesis, Peptide chain elongation prevented.
Spectrum of antibacterial activity Simillar to penicillin . Effective against gram + organisms. Pneumococci , streptococci, staphylococci, corynebacteria. Gram - bacteria. Legionella, bordetella, pertussis, campylobacter jejuni.
Erythromycin Prototype. More effective against gram +, Bacteriostatic but may be at high concerntrations bactericidal,
Elimination Bile and feces
Dosage 250-500 mg 4 times a day
Indications Mycoplasma pneumonia, Legionnaires disease, Diphtheria, Alternative for penicillin allergic patients for infections with streptococcus aureus, atreptococcus puogenes, streptococcus pneumoniae, trepnima pallidum.
Adverse effects Less toxic. Anorexia,nausea, diarrhea . Cholestatic hepatitis.
Clarithromycin Simillar spectrum of antibacterial activity as erythromycin. More active against H. Influenza. Completely absorbed from GIT,
Half life 6 hours
Available as Modified release preparations, Oral suspension, IV form
Indications RTI including atypical pneumonia , Otitis media, Atypical mycobacterial infections , H.pylori eradication
Azithromycin Less active than erythromycin
Route Orally, Food interferes the absorption
Half life 50 hours
Excretion Bile
Adverse effects Gi effects are less than erythromycin
2. Ketolides Telithromycin
Telithromycin First ketolide, a semisynthetic derivatives of macrolides. Spectrum is simillar to macrolides. Effective against erythromycin resistant streptococcus pneumoniae.
Route Orally
Half life 10 hours
Uses Oral treatment of upper and lower RTi
Adverse effects Diarrhea, transient visual disturbances and rarely hepatotoxicity
3. Lincosamidea Clindamycin
Clindamycin Derivative of lincosamides. Spectrum simillar to erythromycin and flucoxacillin.
Route Orally
Available as Oral capsule, oral solution . Clindamycin phosphate for IM and IV use. Topical preparation
Indications Staphylococcal bone and joint infections, Serious intra abdominal infection , Skin and aoft tissue infection , Acne vulgaricus
Created by: Angel thili
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