Merck Manual

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Macrolides

By

Brian J. Werth

, PharmD, University of Washington School of Pharmacy

Medically Reviewed Jun 2022 | Modified Sep 2022
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Topic Resources

Macrolides include the following:

  • Azithromycin

  • Clarithromycin

  • Erythromycin

  • Fidaxomicin

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

Table

Macrolides

Drug

Common Uses

Some Potential Side Effects

Azithromycin

Clarithromycin

Erythromycin

Fidaxomicin

Respiratory infections

Abdominal pain, nausea, vomiting, and diarrhea (especially at higher doses)

Jaundice*

* These side effects are not reported with fidaxomicin.

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 macrolide clarithromycin, harmful effects on the fetus have been observed in animal studies. Therefore, pregnant women should not take clarithromycin except when there is no alternative drug. (See also Drug Use During Pregnancy Drug Use During Pregnancy More than 50% of pregnant women take prescription or nonprescription (over-the-counter) drugs or use social drugs (such as tobacco and alcohol) or illicit drugs at some time during pregnancy... read more .)

Drugs Mentioned In This Article

Generic Name Select Brand Names
Azasite, Zithromax, Zithromax Powder, Zithromax Single-Dose , Zithromax Tri-Pak, Zithromax Z-Pak, Zmax, Zmax Pediatric
Biaxin, Biaxin XL
A/T/S, Akne-mycin, E.E.S., Emcin Clear , EMGEL, E-Mycin, ERYC, Erycette, Eryderm , Erygel, Erymax, EryPed, Ery-Tab, Erythra Derm , Erythrocin, Erythrocin Lactobionate, Erythrocin Stearate, Ilosone, Ilotycin, My-E, PCE, PCE Dispertab , Romycin, Staticin, T-Stat
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