TitleEffects of macrolides and ketolides on mycobacterial infections.
Publication TypeJournal Article
Year of Publication2004
AuthorsBermudez, LE, Yamazaki, Y
JournalCurrent pharmaceutical design
Date Published2004
KeywordsRandomized Controlled Trials as Topic

New macrolides, such as clarithromycin and azithromycin, are active agents to Mycobacterium avium complex (MAC). Both clarithromycin and azithromycin are well-known for the ability to improve the prognosis of AIDS patients with disseminated MAC infection. However, the administration of monotherapy with a macrolide is usually associated with the emergence of drug resistance after a few months of use. Therefore, the recommended treatment for MAC infection involved the use of at least two antibiotics, which includes a macrolide in combination with rifabutin, moxifloxacin and/or ethambutol. When used as prophylactic therapy in AIDS patients, azithromycin is more convenient (1200 mg, once a week) than clarithromycin (500 mg, twice a day). Ketolides are a semi-synthetic derivative of erythromycin A, which differs from erythromycin A by substitution of a 3-keto group for L-cladinose. Telithromycin has a carbamate group linked to an imidazolium and pyridium nucleus at C11-C12. In mice model, both telithromycin and ABT-733 were active in vivo against MAC.