Infectious Disease Book

http://www.fpnotebook.com/

Extended Spectrum Macrolide

Aka: Extended Spectrum Macrolide, Azithromycin, Zithromax, Clarithromycin, Biaxin, Telithromycin, Ketek
  1. See also
    1. Erythromycin
  2. Pharmacokinetics: Half Life
    1. Clarithromycin: 5 hours
    2. Telithromycin: 10 hours
    3. Azithromycin: 68 hours
  3. Dosing: Azithromycin (Zithromax)
    1. Directions
      1. Take more than 1 hour before or 2 hours after food
      2. Adult
        1. Day 1: 500 mg PO qd
        2. Day 2 to 5: 250 mg PO qd
      3. Child
        1. Day 1: 10 mg/kg PO qd (maximum: 500 mg)
        2. Day 2 to 5: 5 mg/kg PO qd (maximum: 250 mg)
      4. Infant under age 6 months
        1. 10 mg/kg/day for 5 days
    2. New preparations
      1. ZMax 2 grams orally x1 dose (Available in 2005)
        1. For uncomplicated community acquired Pneumonia
        2. Vomiting >1 hour after dose - no additional med
        3. Use within 12 hours of reconstituting
      2. References
        1. (2005) Prescribers Letter 12(8):44
  4. Dosing: Clarithromycin (Biaxin)
    1. May take with or without food
    2. Adult: 250 to 500 mg PO bid
    3. Child: 7.5 mg/kg PO bid
  5. Dosing: Telithromycin
    1. Adult: 800 mg PO daily
    2. Course
      1. Acute Exacerbation of Chronic Bronchitis: 5 days
      2. Acute Sinusitis: 5 days
      3. Community acquired Pneumonia: 7 days
  6. Adverse effects
    1. Less Nausea and Vomiting than with Erythromycin
    2. Clarithromycin perverts sense of taste in 20%
  7. Indications: Major indications for newer broad spectrum Macrolides
    1. Erythromycin not tolerated
    2. Single dose Chlamydia trachomatis treatment
    3. Respiratory infections
      1. Otitis Media (Azithromycin)
      2. Community Acquired Pneumonia
        1. Consider Doxycycline as alternative
      3. Acute Sinusitis (Azithromycin)
        1. Not recommended due to growing resistance rates
      4. Non-tuberculous Mycobacterial infections
      5. Helicobacter infections
  8. Contraindications
    1. Telithromycin (Ketek) may cause repiratory failure in Myasthenia Gravis (FDA Black Box Warning)
  9. Preparations: Activity Spectrum
    1. Macrolide resistance is increasing
      1. Resistance to one Macrolide is resistance to all
    2. Spectrum includes organisms covered by Erythromycin
    3. Clarithromycin
      1. Streptococcus Pneumoniae (Pneumococcus)
      2. Staphylococcus aureus
      3. Toxoplasmosis gondii
      4. Mycobacterium leprae
      5. Mycobacterium Avium Complex
      6. Borrelia Burgdorferi
    4. Azithromycin
      1. HaemophilusInfluenzae
      2. Moraxella catarrhalis
      3. Toxoplasmosis gondii
      4. Mycobacterium Avium Complex (Clarithromycin better)
      5. Borrelia Burgdorferi
    5. Telithromycin
      1. Avoid in patients with Myasthenia Gravis due to risk of respiratory failure (FDA Black Box Warning)
      2. Similar to other Extended Spectrum Macrolides
      3. Appears to have greater activity for pneumococcus
      4. May be used in place of other broad spectrum agents
        1. Augmentin
        2. Extended spectrum Fluoroquinolones
      5. References
        1. Fogarty (2003) J Antimicrob Chemother 51:947-55

Biaxin (C0701281)

Concepts Organic Chemical (T109) , Antibiotic (T195)
MSH D017291
English biaxin, Biaxin
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Ketek (C1452484)

Concepts Organic Chemical (T109) , Antibiotic (T195)
MSH C106791
English Aventis brand of telithromycin, Ketek
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Azithromycin (C0052796)

Definition (CHV) a kind of antibiotic drug
Definition (CHV) a kind of antibiotic drug
Definition (CSP) semi-synthetic macrolide antibiotic; related to erythromycin.
Definition (MSH) A semi-synthetic macrolide antibiotic structurally related to ERYTHROMYCIN. It has been used in the treatment of Mycobacterium avium intracellulare infections, toxoplasmosis, and cryptosporidiosis.
Definition (NCI) An azalide, derived from erythromycin, and a member of a subclass of macrolide antibiotics with bacteriocidal and bacteriostatic activities. Azithromycin reversibly binds to the 50S ribosomal subunit of the 70S ribosome of sensitive microorganisms, thereby inhibiting the translocation step of protein synthesis, wherein a newly synthesized peptidyl tRNA molecule moves from the acceptor site on the ribosome to the peptidyl (donor) site, and consequently inhibiting RNA-dependent protein synthesis leading to cell growth inhibition and cell death.
Concepts Organic Chemical (T109) , Antibiotic (T195)
MSH D017963
SnomedCT 391804001, 387531004, 96034006
English Azythromycin, 1-Oxa-6-azacyclopentadecan-15-one, 13-((2,6-dideoxy-3-C-methyl-3-O-methyl-alpha-L-ribo-hexopyranosyl)oxy)-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,12,14-heptamethyl-11-((3,4,6-trideoxy-3-(dimethylamino)-beta-D-xylo-hexopyranosyl)oxy)-, (2R-(2R*,3S*,4R*,5R*,8R*,10R*,11R*,12S*,13S*,14R*))-, XZ-450, (2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dideoxy-3-C-methyl-3-O-methyl-alpha-L-ribo-hexopyranosyl)oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,12,14-heptamethyl-11-[(3,4,6-trideoxy-3-(dimethylamino)-beta-D-xylo-hexopyranosyl]oxy]-1-oxa-6-azacyclopentade, (2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[(2,6-Dideoxy-3-C-methyl-3-O-methyl-alpha-L-ribo-hexopyranosyl)oxy]-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,12,14-heptamethyl-11-[(3,4,6-trideoxy-3-(dimethylamino)-beta-D-xylo-hexopyranosyl]oxy]-1-oxa-6-azacyclopentad, N-methyl-11-aza-10-deoxy-10-dihydroerythromycin A, azithromycin, Azithromycin, Azithromycin - chemical (substance), AZITHROMYCIN, Azithromycin [Chemical/Ingredient], 1-Oxa-6-azacyclopentadecan-15-one, 13-((2,6-dideoxy-3-C-methyl-3-O-methyl-alpha-L-ribo-hexopyranosyl)oxy)-2-ethyl-3,4,10-trihydroxy-3,5,6,8,10,12,14-heptamethyl-11-((3,4,6-trideoxy-3-(dimethylamino)-beta-D-xylo-hexopyranosyl)oxy)-, (2R-(2R*,3S*,4R*,5R*,8R, azythromycin, Azithromycin (product), Azithromycin (substance), Azithromycin - chemical
Swedish Azitromycin
Czech azithromycin
Spanish Azithromycin - chemical, azitromicina (producto), azitromicina (sustancia), azitromicina, Azitromicina
Finnish Atsitromysiini
Russian AZITROMITSIN, АЗИТРОМИЦИН
Japanese アジスロマイシン
Croatian AZITROMICIN
Polish Azytromycyna
French Azithromycine
German Azithromycin
Italian Azitromicina
Portuguese Azitromicina
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Zithromax (C0678143)

Definition (CHV) brand name of azithromycin
Definition (CHV) brand name of azithromycin
Concepts Organic Chemical (T109) , Antibiotic (T195)
MSH D017963
English zithromax [brand name], zithromax, Bayer Brand of Azithromycin Dihydrate, Pfizer Brand of Azithromycin Dihydrate, Mack Brand of Azithromycin Dihydrate, Azadose, Azithromycin Pfizer Brand, Azitrocin, Pfizer Brand of Azithromycin, Ultreon, Zitromax, Zithromax
Sources
Derived from the NIH UMLS (Unified Medical Language System)


telithromycin (C0907410)

Concepts Organic Chemical (T109) , Antibiotic (T195)
MSH C106791
SnomedCT 395260006, 410908003
English telithromycin (medication), telithromycin [Chemical/Ingredient], telithromycin, Telithromycin (product), Telithromycin, Telithromycin (substance), TELITHROMYCIN
Spanish telitromicina (producto), telitromicina, telitromicina (sustancia)
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Clarithromycin (C0055856)

Definition (CSP) semi-synthetic macrolide antibiotic; derivative of erythromycin.
Definition (MSH) A semisynthetic macrolide antibiotic derived from ERYTHROMYCIN that is active against a variety of microorganisms. It can inhibit protein synthesis in bacteria by reversibly binding to the 50S ribosomal subunits. This inhibits the translocation of aminoacyl transfer-RNA and prevents peptide chain elongation.
Definition (NCI) An antibiotic drug used to treat infection. It belongs to the family of drugs called macrolides.
Definition (NCI) A semisynthetic 14-membered ring macrolide antibiotic. Clarithromycin binds to the 50S ribosomal subunit and inhibits RNA-dependent protein synthesis in susceptible organisms. Clarithromycin has been shown to eradicate gastric MALT (mucosa-associated lymphoid tissue) lymphomas, presumably due to the eradication of tumorigenic Helicobacter pylori infection. This agent also acts as a biological response modulator, possibly inhibiting angiogenesis and tumor growth through alterations in growth factor expression. (NCI04)
Definition (PDQ) A semisynthetic 14-membered ring macrolide antibiotic. Clarithromycin binds to the 50S ribosomal subunit and inhibits RNA-dependent protein synthesis in susceptible organisms. Clarithromycin has been shown to eradicate gastric MALT (mucosa-associated lymphoid tissue) lymphomas, presumably due to the eradication of tumorigenic Helicobacter pylori infection. This agent also acts as a biological response modulator, possibly inhibiting angiogenesis and tumor growth through alterations in growth factor expression. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42308&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42308&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1054" NCI Thesaurus)
Concepts Organic Chemical (T109) , Antibiotic (T195)
MSH D017291
SnomedCT 387487009, 83999008
English 6-O-Methylerythromycin, Clarithromycin, Erythromycin, 6-O-methyl-, clarithromycin, clarithromycin (medication), CLARITHROMYCIN, Clarithromycin [Chemical/Ingredient], Clarithromycin (product), Clarithromycin (substance), CLARITH
Swedish Klaritromycin
Czech clarithromycin
Finnish Klatritromysiini
Russian KLARITROMITSIN, КЛАРИТРОМИЦИН
Japanese クラリスロマイシン
Italian 6-O-Metileritromicina, Claritromicina
Polish Klarytromycyna
Spanish 6-O-metileritromicina, claritromicina (producto), claritromicina (sustancia), claritromicina, Claritromicina
French Clarithromycine
German Clarithromycin
Portuguese Claritromicina
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Navigation Tree