What are contraindications of macrolides?

Concomitant administration of macrolides with astemizole, cisapride, pimozide, or terfenadine is contraindicated because potentially fatal cardiac arrhythmias (eg, QT prolongation, ventricular tachycardia, ventricular fibrillation, torsades de pointes) may occur when clarithromycin or erythromycin is given with these …

Why are macrolides selectively toxic?

Macrolides inhibit protein synthesis by binding to the bacterial ribosome in the region of the nascent peptide exit tunnel. Binding of a macrolide in the exit tunnel obstructs the passage of the nascent peptides, so that overall protein synthesis rapidly declines and peptidyl-tRNAs are accumulated.

Is macrolides toxic?

While many macrolides are toxic in nature, others have been shown to display therapeutic properties. Indeed, some of the most well known antibiotic compounds, including erythromycin, are macrolides.

What do macrolides affect?

Macrolides interfere with bacterial protein synthesis and, depending on concentration and bacterial species, are either bactericidal (kill bacteria), or bacteriostatic (inhibit growth of bacteria).

What drugs interact with macrolides?

Drug interactions with carbamazepine, cyclosporin, terfenadine, astemizole and theophylline represent the most frequently encountered interactions with macrolide antibiotics.

Why Tetracycline is contraindicated in pregnancy and pediatric patient?

Tetracyclines are contraindicated in pregnancy because of the risk of hepatotoxicity in the mother, the potential for permanent discoloration of teeth in the fetus (yellow or brown in appearance), as well as impairment of fetal long bone growth.

Which medication is contraindicated in the patient who has been prescribed ceftriaxone?

Ceftriaxone for injection is contraindicated in patients with known allergy to the cephalosporin class of antibiotics. Neonates (≤28 days): Hyperbilirubinemic neonates, especially prematures, should not be treated with ceftriaxone for injection.

In which condition present in the client should macrolides be used with caution?

For infants younger than 1 month of age, macrolides should be used with caution as an association between orally administered erythromycin and azithromycin with infantile hypertrophic pyloric stenosis (IHPS) has been reported.

What is the difference between penicillin and macrolides?

The antimicrobial spectrum of macrolides is slightly wider than that of penicillin, and, therefore, macrolides are a common substitute for patients with a penicillin allergy. Beta-hemolytic streptococci, pneumococci, staphylococci, and enterococci are usually susceptible to macrolides.

Which macrolide is least likely to exhibit drug interaction?

Due to its structural differences, azithromycin does not interact with CYP3A4, SLCO1B1 or SLCO1B3, and therefore has a longer half-life and fewer drug interactions than other macrolides [6, 7].

Can macrolides be taken with food?

Take the medication with or after food. If diarrhoea occurs, drink plenty of water to prevent dehydration. If you experience persistent diarrhoea, stomach pain or bloody stools, do seek medical advice immediately.