Macrolides

Question 1

What are the four macrolide drugs?

Answer 1

1. Azithromycin
2. Clarithromycin
3. Erythromycin
4. Roxithromycin

Question 2

What are the common adverse effects for macrolides?

Answer 2

Nausea
Vomiting
Diarrhoea
Abdominal Pain 
Cramps
Candidal infections

Question 3

What are the rare adverse effects for macrolides?

Answer 3

Hypersensitivity 
Psychiatric disturbances
Ototoxicity (i.e. tinnitus, dizziness, hearing loss)
C-Diff
Prolonged QT interval 
Blood dyscrasias 
Pancreatitis

Question 4

Can the adverse effects of macrolides be dose-related?

Answer 4

SOME adverse effects, i.e. GI, ototoxicity tend to be dose related

Question 5

Is there cross-resistance between the four macrolides?

Answer 5

There is a high degree of cross resistance between erythromycin and the other macrolides.

Question 6

Which macrolide has the highest incidence of GI adverse effects?

Answer 6

Oral erythromycin has a high incidence of GI adverse effects (occur 5-30%) than the other macrolides

Question 7

Which macrolides has the highest drug interactions?

Answer 7

Erythromycin and clarithromycin have more drug interactions than azithromycin and roxithromycin

Question 8

Which macrolides can be used to treat and prevent pertussis?

Answer 8

Azithromycin, Clarithromycin and Erythromycin

Question 9

What are the indications for azithromycin use?

Answer 9

1. Treatment of choice for chlamydial infections
2. Streptococcal pharyngitis/tonsillitis
3. community-acquired pneumonia
4. Px and Tx of Mycobacterium avium complex (MAC) infection (with other agents)
5. Typhoid, paratyphoid
6. Traveller’s diarrhoea
7. Px and Rx of pertussis