macrolides pharmacology

Question 1

Antibacterial spec for macrolides

Answer 1

-Azrithromycin is less active to streptococci and staphylcocci compared to erythromycin and clarithromycin

• Azirthromycin and clairthromycin are more active than erythromycin when it comes to:

1)Atypical bacterial (Mycobacteria , chlamydia trachomatis)

2) Resp infection (H.influenzae , M. cattarhils)

3) Clairthromycin is most active against Mycobacterium avium complex and M. leprae

4) Azithromycin active against Enterobacteriaceae (GI pathogens) like salmonella , E.coli , shigella

Question 2

Indications for macrolides

Answer 2

Community-acquired pneumonia and acute bronchitis

➢ Endocarditis prophylaxis and streptococcal pharyngitis (Alternative to penicillin)

➢ Diphtheria and pertussis (Corynebacterium) prophylaxis and treatment

➢ STD (such as urethritis, gonorrhea, and chancroid) and gastroenteritis (Azithromycin)

➢ Peptic ulcer disease and leprosy (Clarithromycin)

➢ Mycobacterial infections and leprosy (Clarithromycin)

Question 3

Resistance mechanism of bacteria towards Macrolides

Answer 3

Psudeomonas and Acinetobacter intrinsically resistant to macrolides

-methylation or mutation of ribosome
-macrolide inactivation
-efflux of macrolide

Question 4

AE of macrolides

Answer 4

GI effects - nausea, vomiting , diarrhea . ANOREXIA

Elevated liver function enzyme tests and hepatitis