Macrolide Antibiotics

Question 1

How do macrolide antibiotics work?

Answer 1

They inhibit protein synthesis

Question 2

Who are macrolides generally given to?

Answer 2

Penicillin-allergic patients

Question 3

Name 3 of the common macrolides.

Answer 3

• Azithromycin
• Clarithromycin
• Erythromycin

Question 4

What are the indications for the macrolides?

Answer 4

ALL 3 DRUGS HAVE THE SAME INDICATIONS

• Gram positive cocci (but not enterococci and staphylococci)
• Syphilis
• Chlamydia

Question 5

What are the side effects of the macrolides?

Answer 5

Side effects (are increased with erythromycin) and include

• GI disturbances
• Cholestasis
• Increase in QT interval

Question 6

Which of the macrolides causes increased severity of the side effects?

Answer 6

Erythromycin

Question 7

What other clinical feature of macrolides is there?

Answer 7

It inhibits cytochrome p450 (less so with azithromycin), which causes

• Increased levels of warfarin in the blood
• Rhabdomyolysis with statins
• Increased calcineurin inhibitor levels

Question 8

What is rhabdomyolysis?

Answer 8

Rhabdomyolysis is a serious syndrome due to a direct or indirect muscle injury. It results from the death of muscle fibers and release of their contents into the bloodstream. This can lead to serious complications such as renal (kidney) failure.

Question 9

Which of the macrolides causes increased side effects?

Answer 9

Erythromycin