Macrolides

Question 1

What are the Macrolides?

Answer 1

1. Azithromycin (Z pack)
2. clarithromycin (biaxin)
3. erythromycin

Question 2

What are the MOAs of the macrolides?

Answer 2

reversibly binds to 50S subunit & blocks translocation by interference with tRNA release following peptide bond formation (inhibiting the peptide exit tunnel)

Question 3

What atypical bacteria are macrolides effective against?

Answer 3

1. Legionella
2. Chlamydia
3. Mycoplasma

Question 4

What gram positive bacteria are macrolides effective against?

Answer 4

1. Strep. pneumoniae: significant resistance, esp with azithromycin

Question 5

What gram negative bacteria are macrolides effective against?

Answer 5

1. H. influenza

2. M. Catarrhalis

Question 6

What anaerobic bacteria are macrolides effective against?

Answer 6

1. Actinomyces

Question 7

What are the clinical indications for macrolides?

Answer 7

1. Uncomplicated upper and lower respiratory tract infections
2. Mycobacterial infections and chlamydia
3. H. pylori in combination with other agents

Question 8

What are the SE for macrolides?

Answer 8

1. GI effects: Erythromycin> clarithromycin and azithromycin
2. Hepatic events: rare
3. QT prolongation: more common in IV erythromycin