The future role and importance of macrolides
1Infectious Diseases Unit, Cameron Hospital, Windygates, Fife, Scotland.
The Journal of Hospital Infection
|September 1, 1991
Summary
New macrolides like clarithromycin and azithromycin offer improved treatment for respiratory infections. Their enhanced spectrum, tissue penetration, and better tolerance make them superior to older antibiotics.
Area of Science:
- Pharmacology and Infectious Diseases.
- Development of novel antimicrobial agents.
Background:
- Erythromycin, a previous macrolide, had limitations in spectrum, absorption, and gastrointestinal tolerance.
- Therapeutic goals in the 1980s included agents with better tissue penetration and activity against intracellular pathogens.
Purpose of the Study:
- To evaluate the advancements of new macrolides, specifically clarithromycin and azithromycin, over previous antibiotic agents.
- To highlight their potential role in treating respiratory tract infections.
Main Methods:
- Comparative analysis of macrolide properties including antibacterial spectrum, activity, absorption, and tissue penetration.
- Assessment of efficacy against key respiratory pathogens, including beta-lactam-resistant bacteria and intracellular organisms.
Main Results:
- New macrolides demonstrate an extended antibacterial spectrum and increased activity.
- Excellent tissue and intracellular penetration achieved, addressing 1980s therapeutic aims.
- Significant activity against Mycoplasma pneumoniae, Legionella spp., and Chlamydia pneumoniae.
Conclusions:
- Clarithromycin and azithromycin represent significant advances in antibacterial therapy.
- Their properties make them highly suitable for community-acquired pneumonia and other respiratory tract infections.
- Improved dosing regimens and gastrointestinal tolerance favor their clinical adoption over erythromycin.
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