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Updated: Aug 11, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Macrolide antibiotics

T J Pallasch1

  • 1Pharmacology Section, University of Southern California School of Dentistry, Los Angeles, USA.

Dentistry Today
|April 30, 1998
PubMed

Insights

Macrolide antibiotics, including erythromycin, azithromycin, and clarithromycin, are effective for orofacial infections. Newer macrolides offer improved safety and dosing compared to erythromycin.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Oral Medicine

Background:

  • Macrolides are crucial antibiotics for intracellular and respiratory pathogens.
  • Erythromycin is a current standard for acute orofacial infections.
  • Limited data exists on newer macrolides (azithromycin, clarithromycin) for orofacial infections.

Purpose of the Study:

  • To review the efficacy and characteristics of macrolide antibiotics for orofacial infections.
  • To compare newer macrolides with erythromycin in terms of toxicity, pharmacokinetics, and spectrum.
  • To assess the potential clinical significance of azithromycin's properties in orofacial infections.

Main Methods:

  • Literature review of macrolide antibiotics.
  • Pharmacokinetic and pharmacodynamic analysis.
  • Comparison of clinical data and drug interaction profiles.

Main Results:

  • Newer macrolides (azithromycin, clarithromycin) offer advantages over erythromycin: reduced GI toxicity, higher tissue concentrations, broader Gram-negative spectrum, and improved dosing compliance.
  • Macrolides concentrate in inflammatory cells, enhancing delivery to infection sites.
  • Azithromycin lacks significant drug interactions, unlike erythromycin and clarithromycin.
  • Azithromycin's reduced efficacy against Gram-negative cocci and prolonged tissue retention require further clinical investigation for orofacial infections.

Conclusions:

  • Azithromycin and clarithromycin show promise for orofacial infections, with potential benefits in tolerability and patient compliance.
  • While azithromycin's pharmacokinetic profile is advantageous, its clinical impact on Gram-negative cocci in orofacial infections remains to be determined.
  • Further research is needed to fully establish the role of newer macrolides in managing orofacial infections.

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