Macrolides

NaBrian J. Werth, PharmD, University of Washington School of Pharmacy
Imepitiwa/Imerekebishwa May 2024

Nyenzo za Mada

Macrolides are a class of antibiotics that are often used to treat infections in people who are allergic to penicillins.

Macrolides include the following:

  • Azithromycin

  • Clarithromycin

  • Erythromycin

  • Fidaxomicin

Macrolides work by preventing bacteria from producing proteins they need to grow and multiply.

Fidaxomicin is given only by mouth (orally) and is minimally absorbed into the bloodstream when taken orally. It is used to treat Clostridioides difficileinduced colitis but does not do much harm to the other bacteria that normally live in healthy intestines.

Macrolides interact with many other medications (called a drug-drug interaction). Often, the interaction increases the effects, including the side effects, of the other medications. When given with certain other medications, macrolides can increase the risk of sudden cardiac death in people who have long QT syndrome.

Jedwali

(See also Overview of Antibiotics.)

Matumizi ya Macrolides Wakati wa Ujauzito na Kunyonyesha

Macrolides should be taken during pregnancy only when the benefits of treatment outweigh the risks.

With erythromycin and azithromycin, no harmful effects on the fetus have been observed in animal studies, but no well-designed studies have been done in pregnant women. Erythromycin is considered among the safest antibiotics to use during pregnancy. It is considered safer than azithromycin because it has been used more, and thus more is known about it.

With the macrolide clarithromycin, harmful effects on the fetus have been observed in animal studies. Therefore, pregnant women should not take clarithromycin except when there is no alternative medication. (See also Safety of Medications During Pregnancy.)

Use of erythromycin during breastfeeding is generally considered acceptable. Whether other macrolides are safe to use during breastfeeding is unknown. (See also Medication and Substance Use During Breastfeeding.)