Macrolide antibiotics community-acquired pneumonia

So-called atypical bacteria such as Chlamydia pneumoniae and Mycoplasma pneumoniae are the next most important group of community-acquired pneumonia pathogens, accounting for around one case in every eight in hospitalised patients. Atypical bacteria are not sensitive to beta-lactam antibiotics such as penicillins and cephalosporins and the treatment of choice is a macrolide such as erythromycin. 

Indications Community-acquired pneumonia, chronic bronchitis Category Antibiotic, macrolide Half-life 10-13 hours... 

With no comorbidity, the most common organisms associated with a community-acquired pneumonia are At. pneumonia, C. pneumoniae, and viruses. In smokers, the pneumococcus becomes a more frequent pathogen, Macrolide antibiotics have activity against most strains of these organisms (other than viruses) and are therefore commonly used in the treatment of a community-acquired pneumonia. 

Azithromycin, an azalide macrolide antibiotic (500 mg p.o. as a single dose on day 1, followed by 250 mg daily on days 2 to 5 total accumulation dose is 1.5 g), is indicated in the treatment of acute bacterial exacerbations of chronic obstructive pulmonary disease caused by Haemophilus influenzae, Moraxella (Branhamella) catarrhalis, or Streptococcus pneumoniae mild community-acquired pneumonia caused by H. influenzae or S. pneumoniae uncomplicated skin and skin-structure infections caused by Staphylococcus aureus, Streptococcus pyogenes, or S. agalactiae second-line therapy of pharyngitis or tonsillitis caused by S. pyogenes and in nongonococcal urethritis or cervicitis caused by Chlamydia trachomatis. 

Erythromycin A, the major fermentation component of S. erythraea, is a 14-membered ring macrolide that is used by medicinal chemists as the foundation for building semisynthetic derivatives of erythromycin antibiotics. (Macrohdes inhibit bacteria by interfering with microbial protein biosynthesis.) Semisynthetic macrolides are popular with clinicians because they can be administered orally and have relatively low toxicity. They are often used to treat respiratory tract infections, and have been especially effective against conditions such as Legionnaires disease and community-acquired pneumonia. Erythromycin therapy is often prescribed for individuals allergic to penicillin. One of the most widely used macrohde antibiotics... 

Organisms that cause community-acquired pneumonia will be susceptible to broad-spectrum jd-lactam antibiotics, macrolides, or a fluoroquinolone, and usually it is not necessary to add an aminoglycoside. Gentamicin (or other aminoglycosides) never should be used as the sole agent to treat pneumonia acquired in the community or as the initial treatment for pneumonia acquired in... 

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