Macrolides Flashcards
What are examples of macrolide drugs?
- Clarythromycin
- Erythromycin
- Azithromycin
When are macrolides indicated for use?
- Respiratory infection - aleternative to penicillin
- Skin and soft tissue infection - alternative to penicillin
How do macrolides work?
Inhibit bacterial protein synthesis - bind to ribosome and block translocation
What are important adverse reactions to macrolides?
- GI - Nausea/Vomiting, Abdominal pain, Diarrhoea/Antibiotic associated colitis
- Allergy
- Prolonged QT interval
- Ototoxicity
- Cholestatic jaundice
How are macrolides eliminated from the body?
Mostly hepatic with some renal
When is caution required when using macrolides?
Severe hepatic or renal impairment
What drugs can macrolides interact with?
- Warfarin
- Statins
- Amiodarone
- Antipsychotics
- Quinine
- Quinolone
- Antibiotics
- SSRI’s
What effect do macrolides have on the cytochrome P450 system?
Inhibit P450 enzymes
What problem can occur when macrolides are given with statins?
Myopathy
What drugs do you need to be cautious with when giving macrolides in terms of prolonging QT interval?
- Amiodarone
- Quinolone
- Quinine
- Antipsychotics
- Antibiotics
- SSRIs
Over what time period should IV clarythromycin be given, and why?
over 60 minutes - avoid arrythmias
What dose of clarythromycin would you start someone on for a respiratory infection?
250 mg twice daily - 7-14 days
What dose of clarythromycin would you start someone on for H. pylori erdication therapy when using amoxicillin?
500 mg twice daily
How would you monitor efficacy of macrolide use?
- Symptom/Signs of infection
- Blood tests - CRP, WCC
