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The new macrolide antibiotics: azithromycin, clarithromycin, dirithromycin, and roxithromycin
1Ohio State University (OSU), College of Pharmacy 43210.
The Annals of Pharmacotherapy
|January 1, 1992
Summary
Four new macrolide antibiotics, including azithromycin and clarithromycin, show promise over erythromycin. These newer macrolides offer improved antimicrobial activity, less frequent dosing, and fewer gastrointestinal side effects.
Area of Science:
- Pharmacology
- Infectious Diseases
- Medicinal Chemistry
Background:
- Erythromycin, a widely used macrolide antibiotic, has limitations including frequent dosing and gastrointestinal side effects.
- Newer macrolide antibiotics have been developed to address these limitations.
Purpose of the Study:
- To review the chemistry, antimicrobial spectrum, pharmacokinetics, clinical trials, adverse effects, and drug interactions of four new macrolide antibiotics: azithromycin, clarithromycin, dirithromycin, and roxithromycin.
- To compare the efficacy and safety of these new macrolides against erythromycin.
Main Methods:
- Information was gathered from comparative clinical trials, abstracts, conference proceedings, and review articles.
- Emphasis was placed on comparative clinical trials involving the new macrolide antibiotics.
- Data from English-language human studies were evaluated based on sample size, dosage, and therapeutic response.
Main Results:
- The newer macrolides (azithromycin, clarithromycin, dirithromycin, roxithromycin) may offer advantages over erythromycin.
- Potential advantages include greater antimicrobial activity, longer elimination half-life allowing less frequent administration, and a lower incidence of adverse gastrointestinal effects.
Conclusions:
- Newer macrolide antibiotics appear to be an improvement over erythromycin.
- Further clinical studies are needed to definitively establish the role of these new macrolide agents.