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Macrolides and ketolides: azithromycin, clarithromycin, telithromycin.

Jerry M Zuckerman1

  • 1Jefferson Medical College, Philadelphia, PA, USA. zuckermj@einstein.edu

Infectious Disease Clinics of North America
|August 17, 2004
PubMed
Summary

Advanced macrolides like azithromycin and clarithromycin offer improved activity, dosing, and tolerability over erythromycin. This review covers their pharmacokinetics, antimicrobial use, and side effects.

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Area of Science:

  • Pharmacology
  • Microbiology
  • Infectious Diseases

Background:

  • Erythromycin is a foundational macrolide antibiotic.
  • Advanced macrolides and ketolides represent significant therapeutic improvements.
  • Understanding these agents is crucial for modern antimicrobial therapy.

Purpose of the Study:

  • To review the pharmacokinetics, antimicrobial activity, clinical applications, and adverse effects of advanced macrolides (azithromycin, clarithromycin) and the ketolide telithromycin.
  • To compare these agents with erythromycin, highlighting their distinct advantages.

Main Methods:

  • Literature review of pharmacokinetic and pharmacodynamic data.
  • Analysis of antimicrobial spectrum and clinical efficacy studies.
  • Compilation of reported adverse effects and tolerability profiles.

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Main Results:

  • Azithromycin, clarithromycin, and telithromycin exhibit enhanced antimicrobial spectra compared to erythromycin.
  • These agents demonstrate improved pharmacokinetic and pharmacodynamic properties, allowing for once-daily dosing.
  • Generally improved tolerability profiles are noted for these newer agents.

Conclusions:

  • Advanced macrolides and ketolides offer significant therapeutic benefits over erythromycin.
  • Their favorable properties make them valuable options for treating various bacterial infections.
  • Further research may elucidate long-term outcomes and resistance patterns.