acts on actively dividing cells only; binds to 50S ribosomes inhibiting translocation and protein synthesis
What is the MOA of Macrolides?
efflux, ribosomal protection, esterase to cleave lactone, mutation of 50s unit
What methods of resistance do bacteria utilize against Macrolides?
rare liver damage, prolonged QT interval/ arrhythmia, patients who take anti-arrhythmia meds
What are toxicity concerns associated with Macrolides?
N&V, CYP450 inhibition
What are side effects associates with Macrolides?
ketalized due to acid
How do Macrolides fare in the GI tract?
lactone hydrolysis will occur
How do Macrolides fare in the presence of bases & enzymes?
erythromycin, clarithromycin, azithromycin, telithromycin, fidaxomicin
What are our macrolides?
Lincomycin, Clindamyin
What are our Lincoasamines?
aerobic gm +; anaerobic gm + & gm -
Spectrum of Lincomycin?
aerobic +/-; anaerobic +/-
Spectrum of Clindamycin?
Clindamycin, clindamycin palmitate, clindamycin phosphate
What our three forms of Clindamycin?
mycoplasma pneumonia, rti, otitis media
Clarithromycin tx?
less Gm (+) activity
How does Azithromycin's spectrum compare to Erythromycin?
ketolide; telithromycin
What functional group is present in a Macrolide that increases the binding affinity to 50s ribosome 10x? What is the macrolide?
b
All Macrolides are considered ______ except for Fidaxomicin.
a) bactericidal
b) bacteriostatic
mrsa, enterococcus, c.diff
Lincomycin is a relatively broad spectrum antibiotic, what organisms is it NOT effective against?
inflammatory acne vulgaris, bacteriodes fragilis
Clindamycin tx?