In a group such as macrolides, the listdrugs large, which indicates a sufficient breadth of therapeutic use. These drugs are safe and are used in many diseases of infectious nature, including those caused by intracellular parasitic bacteria. They are suitable for the treatment of diseases of the skin, joints, respiratory system, including bronchitis and pneumonia of varying severity.
Heavy pneumonia is also used.macrolides, the list of drugs which is indicated in the standard treatment protocols. However, they contain information about the need to combine with other antimicrobial agents. Most often they are used together with cephalosporins. This combination allows you to mutually increase the effectiveness of both drugs, without increasing their toxicity.
Macrolide Classification
The most competent and convenient classificationThis group of drugs is a chemical. It reflects differences in the structure and origin of the antibiotics of the group called "Macrolides". The list of drugs will be given below, and the substances themselves are distinguished by:
- 14-membered macrolides:
- natural origin - erythromycin and oleandomycin;
- semi-synthetic - clarithromycin and roxithromycin, dirithromycin and flurithromycin, telithromycin.
2. Azalide (15-membered) macrolides: azithromycin.
3. 16-membered macrolides:
- natural origin midecamycin, spiramycin and josamycin;
- semi-synthetic - midekamycin acetate.
This classification reflects only the structural features of class drugs. The list of trade names is presented below.
Drug List
Macrolides - a list of which is verywide In total, as of 2015, there are 12 drugs of this class. And the number of preparations containing these active substances is much higher. Many of them can be found in the pharmacy network and taken to treat a number of diseases. Moreover, some drugs are not available in the CIS, as it is not registered in the pharmacopoeia. Examples of trade names of drugs containing macrolides are as follows:
- Erythromycin is often produced in preparations with the same name, as well as included in the complex medicines "Zenerit" and "Isotrexin".
- Oleandomycin - medicinal substance of the drug "Oletetrin".
- Clarithromycin:Clabs and Claricar, Clerimed and Klacid, Clairon and Lecoklar, Pilobact and Fromilid, Ecozetrin and Erasid, Zimbactar and Arvitsin, Kispar "and" Klarbakt "," Klaritrosin "and" Klaritsin "," Klasine "and" Coater "," Clerimed "and" Romiklar "," Seydon "and" CP-Claren ".
- Roxithromycin is often found in the form of a generic trade name, and is also included in the following drugs: Xitrocin and Romik, Elrox and Rulitsin, Esparoxy.
- Azithromycin:"Azivok" and "Azidrop", "Azimitsin" and "Azitral", "Azitroks" and "Azitrus", "Zetamax" and "Zi-Factor", "Zitnob" and "Zitrolid", "Zitratsin" and "Sumaklid", "Sumamed" and "Sumamoks", "Sumatrolid" and "Tremaks-Sanovel", "Hemomycin" and "Ecomed", "Safotsid".
- Midecamycin is available in the form of the drug "Macropen".
- Spiramycin is available as "Rovamycin" and "Spiramycin-Vero."
- Dirithromycin, flurithromycin, and also telithromycin and josamycin are not produced in the CIS.
The mechanism of action of macrolides
This specific pharmacological group isMacrolides - has a bacteriostatic effect on a susceptible cell of the pathogen of infectious diseases. It is possible to exert a bactericidal effect only in high concentrations, although this has been proven only in laboratory tests. The only mechanism of action of macrolides is the inhibition of protein synthesis of a microbial cell. This disrupts all the vital processes of a virulent microorganism, as a result of which it dies after some time.
The mechanism of inhibition of protein synthesis is associated withthe addition of bacterial ribosomes to the 50S subunit. They are responsible for building up the polypeptide chain during DNA synthesis. Thus, the synthesis of structural proteins and bacterial virulence factors is disrupted. At the same time, high specificity specifically for the bacterial ribosome determines the relative safety of macrolides for the human body.
Comparison of macrolides and antibiotics of other classes
Macrolides are similar in properties to tetracyclines, butmore secure. They do not disrupt the development of the skeleton in childhood. Like tetracyclines with fluoroquinolones, macrolides (the list of drugs is presented above) are able to penetrate into the cell and create therapeutic concentrations in the three compartments of the body. It is important in the treatment of mycoplasma pneumonia, legionellosis, campylobacteriosis and chlamydial infection. In this case, macrolides are safer than fluoroquinolones, although they are less effective.
All macrolides are more toxic than penicillins, butthe safest in terms of the likelihood of developing allergies. At the same time, penicillin antibiotics are record holders in safety, but they tend to cause allergies. Thus, having a similar spectrum of antimicrobial activity, macrolides can replace aminopenicillins for infections of the respiratory system. Moreover, laboratory studies show that macrolides reduce the effectiveness of penicillins when taken together, although modern treatment protocols allow them to be combined.
Macrolides during pregnancy and in child therapy
Macrolides are safe drugs.on a par with cephalosporins and penicillins. This allows their use in pregnancy and in the treatment of children. They do not disrupt the development of the bone and cartilage skeleton, do not have teratogenic properties. Only azithromycin should be limited to use in the third trimester of pregnancy. In pediatric therapy, both penicillins, cephalosporins, and macrolides, listed in standard protocols for the treatment of diseases, can be used without the risk of toxic lesions of the body.
Description of some macrolides
Macrolides (drugs, we have listed above) inclinical practice are widely used, including in the CIS. Four of their representatives are most commonly used: clarithromycin and azithromycin, midecamycin and erythromycin. Spiramycin is much less commonly used. The effectiveness of macrolides is about the same, although it is achieved in different ways. In particular, clarithromycin and midekamitsin to achieve a clinical effect should be taken twice a day, while azithromycin lasts 24 hours. A single dose per day is enough to treat infectious diseases.
Erythromycin is the shortest of allmacrolides. It must be taken 4-6 times a day. Therefore, it is most often used in the form of local forms for the treatment of acne and skin infections. It is noteworthy that macrolides for children are safe, although they can cause diarrhea.
