Erythromycin interaction with chloramphenicol

Clinically important, potentially hazardous interactions with allopurinol, bromelain, chloramphenicol, demeclocydine, doxycydine, erythromycin, imipenem/cilastatin, methotrexate, minocycline, oxytetracycline, sulfonamides, tetracycline... 

Oral drugs with a markedly bitter taste may lead to poor patient compliance if administered as a solution or syrup. The prodrug approach has been used to improve the taste of chloramphenicol (20), clindamycin, erythromycin, and metronidazole.19 A prodrug such as chloramphenicol palmitate (21), with LogP of around 10, does not dissolve in an appreciable amount in the mouth and, therefore, does not interact with the taste receptors. 

The location of binding of EF-Tu on ribosomes has been established directly by cryo-EM. It binds both to the L7/L12 stalk and to the body of the 505 ribosomal subunit. The other end of the P site is at the pepti-dyltransferase locus and has been photochemically labeled by azide derivatives of aminoacyl groups bound to a tRNA. The labeling is primarily in the 505 subunit of E. coli ribosomes and involves the central loop of domain V (residues 2043 - 2625) of the 235 RNA. Residues U2584 and U2585 are major sites of crosslinking (see Fig. 29-14). The presence of nearby sites of mutation leading to resistance to chloramphenicol or erythromycin (Box 29-B) served to confirm the central loop as part of the peptidyltrans-ferase. Domain II of 235 RNA is also involved, and there is evidence that the unique sequence UGG at positions 807-809 may also interact with the CCA end of tRNA in the P site. ... 

Besides being associated with pseudomembranous colitis, clindamycin can also cause an adverse interaction with antidiarrheals, chloramphenicol (Chloromycetin), and erythromycin. 

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