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The macrolide ring is the lactone (cyclic ester) at upper left. Clarithromycin Roxithromycin. Macrolides are a class of mostly natural products with a large macrocyclic lactone ring to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. The lactone rings are usually 14-, 15-, or 16-membered.
A two-hour intravenous infusion of 600 mg of Lincomycin achieves average peak serum levels of 15.9 μg/mL and yields therapeutic levels for 14 h for most susceptible gram-positive organisms. Urinary excretion ranges from 4.9% to 30.3% (mean: 13.8%). The biological half-life after IM or IV administration is 5.4 ± 1.0 h.
Roxithromycin is a semi-synthetic macrolide antibiotic. It is used to treat respiratory tract, urinary and soft tissue infections. Roxithromycin is derived from erythromycin, containing the same 14-membered lactone ring. but with an N-oxime side chain attached to the ring. Roxithromycin was patented in 1980 and approved for medical use in 1987. [1]
Tacrolimus was discovered in 1987; it was among the first macrolide immunosuppressants discovered, preceded by the discovery of rapamycin (sirolimus) on Rapa Nui (Easter Island) in 1975. [44] It is produced by a soil bacterium, Streptomyces tsukubensis. [45] The name tacrolimus is derived from "Tsukuba macrolide immunosuppressant". [46]
Azithromycin is a member of macrolides that are a class of antibiotics with a cyclic structure with a lactone ring and sugar moieties. Macrolides can inhibit CYP3A4 by a mechanism called mechanism-based inhibition (MBI), which involves the formation of reactive metabolites that bind covalently and irreversibly to the enzyme, rendering it inactive.
Tetracyclines are generally used in the treatment of infections of the urinary tract, respiratory tract, and the intestines and are also used in the treatment of chlamydia, especially in patients allergic to β-lactams and macrolides; however, their use for these indications is less popular than it once was due to widespread development of resistance in the causative organisms.
While generally regarded as safe during breastfeeding, its use by the mother during the first two weeks of life may increase the risk of pyloric stenosis in the baby. [5] [6] This risk also applies if taken directly by the baby during this age. [7] It is in the macrolide family of antibiotics and works by decreasing bacterial protein production ...
It is in the macrolide class and works by slowing down bacterial protein synthesis. [3] Clarithromycin resistance is already a major challenge to healthcare systems and such resistance is spreading, leading to recommendations to test the susceptibility of pathogenic organisms to the antibiotic before commencing clarithromycin therapy.
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