Macrolides: list of drugs, description

In a group such as macrolides, the list of drugs is large, indicating a sufficient breadth of therapeutic use. These medicinal substances are safe and are used for many infectious diseases, 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.

In severe pneumonia, macrolides are also used, the list of preparations of which is indicated in standard protocols of treatment. However, they contain information on the need to combine with other antimicrobials. Most often they are used together with cephalosporins. This combination allows for a mutual increase in the effectiveness of both drugs without increasing their toxicity.

Classification of macrolides

The most competent and convenient classification of this group of drugs is chemical. It reflects the differences in the structure and origin of the group's antibiotics with the name "Macrolides." The list of drugs will be given below, and the substances themselves are distinguished by:

1. 14-member macrolides:

• Natural origin - erythromycin and oleandomycin;
• Semisynthetic - clarithromycin and roxithromycin, dirithromycin and flurithromycin, telithromycin.

2. Azalid (15-member) macrolides: azithromycin.

3. 16-membered macrolides:

• Natural origin - midekamycin, spiramycin and josamycin;
• Semisynthetic - midekamycin acetate.

This classification reflects only structural features of class drugs. The list of trade names is presented below.

List of drugs

Macrolides are drugs, the list of which is very wide. In total, as of 2015, there are 12 drugs of this class. And the number of drugs containing these active ingredients is much higher. Many of them can be found in the pharmacy network and taken to treat a number of diseases. And some of the drugs are not available in the CIS, as it is not registered in the pharmacopoeia. Examples of trade names for preparations containing macrolides are as follows:

• Erythromycin is often produced in preparations with the same name, and is also included in the complex medicines Zinerit and Isotrexin.
• Oleandomycin is a medicinal substance of the preparation "Oletetrin".
• Clarithromycin: Clabax and Claricar, Clerimed and Klacid, Cleron and Lecoclar, Pylobacter and Fromilide, Ecositrin and Erasid, Zimbaktar and Arvitsin, "Kispar" and "Clarcat", "Claritrosin" and "Claricin", "Klasine" and "Coater", "Clerimed" and "Romiklar", "Seydon" and "SR-Claren".
• Roxithromycin is often found in the form of a non-proprietary trade name, and is also included in the following preparations: Xitrocin and Romik, Elroks and Rulicin, Esparoxi.
• Azithromycin: Azivok and Azidrop, Azimycin and Azitral, Azitrox and Azitrus, Zetamaks and Zi Factor, Zytnob and Zitrolide, Zitracin and Sumaclid "," Sumamed "and" Sumamox "," Sumatrolid "and" Tremaks-Sanovel "," Chemomycin "and" Ecomed "," Safocid ".
• Midekamycin is available in the form of "Macropen".
• Spiramycin is available as "Rovamycin" and "Spiramycin-Vero".
• Dirithromycin, flurithromycin, as well as telithromycin and josamycin are not available in the CIS.

Mechanism of action of macrolides

This specific pharmacological group - macrolides - has a bacteriostatic effect on the susceptible cell of the causative agent of infectious diseases. Only in high concentrations bactericidal effect is possible, although this has been proved only in laboratory studies. The only mechanism of action of macrolides is the inhibition of protein synthesis of the microbial cell. This violates all the processes of vital activity of a virulent microorganism, as a result of which, after some time, it dies.

The mechanism of inhibition of protein synthesis is associated with the attachment of bacterial ribosomes to the 50S subunit. They are responsible for building up the polypeptide chain in the synthesis of DNA. Thus, synthesis of structural proteins and virulence factors of the bacterium is broken. At the same time, high specificity to the bacterial ribosome causes the relative safety of macrolides for the human body.

Comparison of macrolides and antibiotics of other classes

Macrolides are similar in properties to tetracyclines, but are safer. 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 inside the cell and create therapeutic concentrations in three compartments of the body. This is important in the treatment of mycoplasmal pneumonia, legionellosis, campylobacteriosis and chlamydia infection. Moreover, macrolides are safer than fluoroquinolones, although they are less effective.

All macrolides are more toxic than penicillins, but the safest in terms of the likelihood of developing allergies. At the same time, penicillin antibiotics are safety record holders, but are prone to cause allergies. Thus, having a similar spectrum of antimicrobial activity, macrolides can replace aminopenicillins in infections of the respiratory system. Moreover, laboratory studies show that macrolides reduce the effectiveness of penicillins when taken together, although modern treatment protocols allow for their combination.

Macrolides in pregnancy and in pediatric therapy

Macrolides are safe drugs along with cephalosporins and penicillins. This allows them to be used in pregnancy and in the treatment of children. They do not violate the processes of development of the bone and cartilaginous skeleton, they do not have teratogenic properties. Only azithromycin should be limited in use in the third trimester of pregnancy. In children's therapy, penicillins, and cephalosporins, and macrolides, listed in the standard protocols for the treatment of diseases, can be used without the risk of toxic damage to the body.

Description of some macrolides

Macrolides (drugs, the list we cited above) in clinical practice are widely used, including in the CIS. The most commonly used are their four representatives: clarithromycin and azithromycin, midekamycin and erythromycin. Spiramycin is much less commonly used. The effectiveness of macrolides is approximately the same, although it is achieved in different ways. In particular, clarithromycin and midekamycin to achieve a clinical effect should be taken twice a day, while azithromycin is valid for 24 hours. It is enough to take one dose per day for the treatment of infectious diseases.

Erythromycin is the shortest of all macrolides. It should 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.