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Macrolides ˈmak-rə-ˌlīd

By Hans P. Schlecht, MD, MSc, Assistant Professor of Medicine, Department of Medicine, Division of Infectious Diseases & HIV Medicine, Drexel University College of Medicine ; Christopher Bruno, MD, Assistant Professor of Medicine, Division of infectious Diseases & HIV Medicine, Drexel University College of Medicine

Macrolides are a class of antibiotics that are often used to treat infections in people who are allergic to penicillins.

Macrolides include the following:

  • Azithromycin

  • Clarithromycin

  • Erythromycin

  • Fidaxomicin

  • Telithromycin

Macrolides work by preventing bacteria from producing proteins they need to grow and multiply.

Macrolides interact with many other drugs (called a drug-drug interaction). Often, the interaction increases the effects, including the side effects, of the other drugs. When given with certain other drugs, macrolides can increase the risk of sudden cardiac death in people who have long QT syndrome.

Macrolides

Drug

Common Uses

Some Side Effects

Azithromycin

Clarithromycin

Erythromycin

Fidaxomicin

Telithromycin

Respiratory infections

For azithromycin: Chlamydial infections of the reproductive organs and urinary tract

Nausea, vomiting, and diarrhea (especially at higher doses)

Jaundice

Abnormal heart rhythms (arrhythmias)

For telithromycin: Risk of respiratory failure in people with myasthenia gravis (telithromycin is not given to people with myasthenia gravis)

Use of Macrolides During Pregnancy and Breastfeeding

Macrolides should be taken during pregnancy only when the benefits of treatment outweigh the risks.

With erythromycin and azithromycin, no harmful effects on the fetus have been observed in animal studies, but no well-designed studies have been done in pregnant women. Erythromycin is considered among the safest antibiotics to use during pregnancy. It is considered safer than azithromycin because it has been used more, and thus more is known about it.

With the other macrolides, harmful effects on the fetus have been observed in animal studies.

Use of erythromycin during breastfeeding is generally considered acceptable. Whether other macrolides are safe to use during breastfeeding is unknown.

Resources In This Article

Drugs Mentioned In This Article

  • Generic Name
    Select Brand Names
  • KETEK
  • ZITHROMAX
  • DIFICID
  • BIAXIN
  • ERY-TAB, ERYTHROCIN