MOA

ADR

USES

• Bacteriostatic at low but cidal at higher concentration
• Acts by inhibiting bacterial protein synthesis
• It combines with 50s ribosome subunit and interferes with translocation

• Remarkably safe drug but side effect do occurs:
• Gastrointestinal– Epigastric pain, diarrhea– stimulate motilin receptor in GI
• Very high dose- reversible hearing impairment
• Hypersensitivity- Rashes and fever
• Hepatitis with cholestatic jaundice- resembling viral hepatitis or obstructive jaundice with estolate ester

• Alternative to penicillin in:
  • Streptococcal pharyngitis, tonsillitis
  • CAP- due to Pneumococci or H. influenza
  • Rheumatic fever and SABE
  • Diphtheria
  • Tetanus
  • Syphilis and Gonorrhea
  • Leptospirosis
• DOC
  • Atypical pneumonia- by Mycoplasma pneumoniae
  • Whooping cough
  • Chancroid

Drugs

ADR

USES

Azithromycin

• Mild GI upset, abdominal pain, headache, dizziness

• DOC in
  • Legionnaires pneumonia
  • Chlamydia trachomatis- Urethritis, genital infections, LGV, Chlamydia pneumonia, Trachoma
  • Donovanosis
  • Chancroid
• Pharyngitis, Tonsillitis, sinusitis, otitis media
• Pneumonia
• Acute exacerbation of COPD
• Multidrug resistant Typhoid
• MAC in AIDS patient
• Toxoplasmosis

Drugs

ADR

USES

Clarithromycin

• Same as Erythromycin
• But GI tolerance is better
• High dose- reversible hearing loss
• Pseudomembran ous enterocolitis
• Hepatic dysfunction
• Rhabdomyolysis

• Upper and lower respiratory tract infection- Sinusitis, otitis media, whooping cough, atypical pneumonia
• Skin and skin appendage infection due to – Strep. Pyogens, Staph. Aureus
• Triple regimen in H. Pylori
• DOC in MAC infection in AIDS
• 2^nd line- Leprosy