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Macrolide Antibiotics

Generic name: Erythromycin

Commercial name: Erythrocin 250 ,500 mg tab, 100mg/5ml susp,100mg/ml ped. drops;

Etrocin, Eryster: 250mg tab, 100mg/5ml dry syp, Emthro250mg tab, 125mg/5ml suspension.

Mechanicm of action

Acts by inhibiting bacterial protein synthesis. It interferes with 50 S ribosome sub units and interferes with translocation.

Indications

  • Alternative to penicillin G and other penicillins for the treatment of patients hypersensitive to penicillin.
  • Treatment of upper and lower respiratory tract, skin and soft tissue infections of mild to moderate severity.
  • As a first choice of drugs for atypical pneumonia and whooping cough.

Warnings/Precautions and Contraindications

  • Psuedomembranous colitis and hepatic dysfunction reported.
  • Contraindicated in concomitant terfenadine.

Adverse effects

  • Nausea, vomiting, diarrhoea, anorexia, abdominal pain, hepatic dysfunction, abnormal LFTs, allergic reactions and superinfection.

Generic name: Clarithromycin

Commercial name: Claribid 250, 500 mg tab, 250mg/5ml dry syp; Clarimac 250, 500mg tabs.

Mechanism of action

Acts by inhibiting bacterial protein synthesis. It interferes with 50S ribosome sub units and interferes with translocation.

Indications

  • Treatment of upper and lower respiratory tract infections, sinusitis, otitis media, atypical pneomonia skin and skin structure infections due to strp. pyogenes and staph. aureus.
  • It is the first line of treatment in MAC infections in AIDS patients and second line of treatment for other atypical mycobacteria diseases in leprosy patients.

Warnings/Precautions and Contraindications

  • W/P: Avoid in pregnancy. Psuedomembranous colitis reported. Adjust dose with severe renal impairment.
  • Contraindicated in concomitant cisapride, pimozide, terfenadine.

Adverse effects

  • Nausea, diarrhoea, abnormal taste, dyspepsia, abdominal pain, headache, vomiting, rash.

Generic name: Azithromycin

Commercial name: Azithral 250, 500mg cap and 250 mg /5ml dry syr; Aziwok 250 mg cap, 100mg, 100mg/5ml and 200mg/5ml susp.; Aziwin 100, 250, 500 mg tab.

Mechanism of action

Acts by inhibiting bacterial protein synthesis. It interferes with 50S ribosome sub units and interferes with translocation.

Indications

  • It is the first choice of treatment in Legionairre's pneumonia, Chalymidial tracomatis.
  • Other indications include pharyngitis, tonsillitis, sinusitis, acute exacerbations of chronic bronchitis, streptococcal and some staphylococcal skin and soft tissue infections and gonorrhea.

Warnings/Precautions and Contraindications

  • Monitor theophylline terfenadine, cyclosporine, phenytoin and warfarin. May increase digoxin and carbamazepine level.

Adverse effects

  • Mild gastric upset, abdominal pain headache and dizziness.
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