Macrolides

Background

Mechanism of Action

• Binds the 23S subunit of the 50S ribosome, blocking protein synthesis

Pharmacokinetics and Pharmacodynamics

• Generally considered to be bacteriostatic
• Mostly time-dependent killing with prolonged post-antibiotic effect, efficacy best predicted by AUC₂₄:MIC
  • However, azithromycin and other ketolides have concentration-dependent bactericidal action with prolonged post-antibiotic effect

Members

• Azithromycin
• Clarithromycin
• Erythromycin
• Fidaxomicin
• Spiramycin