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Macrolide Antibiotics Overview

Aug 17, 2025

Overview

This lecture covers the macrolide class of antibiotics, focusing on their mechanism, key members (erythromycin and azithromycin), spectrum of activity, and dosing advantages.

Macrolide Antibiotics Overview

  • Macrolides inhibit protein synthesis by targeting the 50S ribosomal subunit in bacteria.
  • They were first discovered in 1952 from the Streptomyces genus; about half of all antibiotics come from this group.
  • The earliest macrolide identified was erythromycin.

Mechanism of Action

  • Macrolides block the formation of certain amino acid combinations during protein synthesis.
  • This inhibition results in bacteriostatic action (stops bacterial growth, does not directly kill bacteria).

Comparison: Erythromycin vs. Azithromycin

  • Erythromycin: mainly effective against gram-positive bacteria; limited by inability to enter gram-negative bacteria easily.
  • Azithromycin (Z-Pak): more broad-spectrum, effective also against gram-negative bacteria.
  • Erythromycin half-life: 1.5 hours; Azithromycin half-life: 68 hours.

Advantages of Azithromycin (Z-Pak)

  • Long half-life allows for once-daily dosing and shorter overall treatment (e.g., three pills over three days).
  • Shorter, simpler dosing improves patient compliance and treatment success.

Key Terms & Definitions

  • Macrolides — A class of antibiotics that inhibit bacterial protein synthesis at the 50S ribosomal subunit.
  • Bacteriostatic — Describes drugs that stop bacterial growth without killing the bacteria.
  • Gram-positive bacteria — Bacteria with a thick peptidoglycan cell wall that retains Gram stain.
  • Gram-negative bacteria — Bacteria with a thinner cell wall and outer membrane, do not retain Gram stain.
  • Half-life — Time required for the concentration of a drug in the body to reduce by half.
  • Streptomyces — A bacterial genus known as a major source of antibiotics.

Action Items / Next Steps

  • Review mechanisms of action for other protein synthesis inhibitors.
  • Memorize differences between erythromycin and azithromycin, especially spectrum and dosing.
  • Prepare for potential exam questions on macrolide antibiotics.