Roxithromycin: review of its antimicrobial activity

Area of Science:

• Pharmacology
• Microbiology
• Infectious Diseases

Background:

• Roxithromycin is a semi-synthetic 14-membered macrolide antibiotic.
• Its structure is modified for stability in the gastric environment.
• Its in-vitro activity is comparable to other macrolides.

Purpose of the Study:

• To review the in-vitro and in-vivo activity of roxithromycin.
• To highlight its spectrum of activity against various pathogens.
• To discuss its cellular penetration and post-antibiotic effects.

Main Methods:

• Literature review of roxithromycin's pharmacological properties.
• Analysis of in-vitro antimicrobial susceptibility data.
• Evaluation of in-vivo efficacy studies.

Main Results:

• Roxithromycin exhibits activity against Gram-positive and Gram-negative cocci and bacilli.
• It is effective against atypical pathogens like Mycobacterium avium complex, Helicobacter pylori, and Borrelia spp.
• The antibiotic penetrates host cells (macrophages, PMNs) and targets intracellular pathogens (Legionella, Chlamydia, Mycobacterium, Rickettsia, Borrelia).
• A significant post-antibiotic effect was observed, dependent on pathogen, concentration, and exposure duration.
• In vivo, roxithromycin demonstrated efficacy comparable to or exceeding other macrolides in various infections.

Conclusions:

• Roxithromycin possesses a broad spectrum of activity, including against intracellular and atypical pathogens.
• Its pharmacokinetic properties, such as cellular penetration and post-antibiotic effect, contribute to its efficacy.
• Roxithromycin is a valuable therapeutic option for a wide range of bacterial infections.