Macrolide and Lincosamides Flashcards
What are the macrolides?
- Erythromycin
- Clarithromycin
- Azithromycin
What drug is a lincosamide?
Clindamycin
What is the MOA of Macrolides?
Primarily bateriostatic via inhibition of RNA-dependent protein synthesis
What type of bacteria is Erythromycin effective against?
Gram (+) aerobic and anaerobic cocci and spirochetes
NOT against most gram (-) which are most oral infections
What microorganisms are generally resistant to Erythromycin?
- Aggregatibacter actinomycetemcomitans
- Fusobacterium
- MRSA
Where is erythromycin metabolized and excreted?
- Metab in liver
- Excreted in the bile, feces (primarily) and urine
What is a common side effect of erythromycin?
GI intolerance
Special dose forms are designed to minimize GI upset
Although they are functionally the same as erythromycin, what improved properties do clarithromycin and azithromycin have?
- Acid stability
- Oral absorption
- Pharmokinetic properties
Which macrolide has the best activity against gram (-) anaerobes (fusobacteria, Prevotella, Porphyromonas, Aggregatibacter actinomycetemcomitans) making is the best for orofacial infections?
Azithromycin
What macrolide is most active against gram (+) anaerobes (actinomyces, propionibacterium, lactobacillus)?
Clarithromycin
What macrolide has a plasma half-life of 68-72 hrs and is dosed as 500mg stat, then 250mg/day for 2 to 5 mroe days?
Azithromycin
Even after they finish the antibiotic the drug can remain in their system for days
What is the preferred drug and dose for management of acute periapical abscesses?
Azithromycin 500mg/day for 3 days
compared to amoxicillin/clavulanic acid 3x day for 5-10 days
