Macrolides, specific agents

Erythromycin estolate in conjunction with rifampin (both drugs administered orally) can be recommended for the treatment of Rhodococcus equi pneumonia in foals. Early diagnosis of the infection and prompt initiation of therapy considerably increase the effectiveness of treatment. Apart from this specific indication, macrolide antibiotics (including erythromycin) and lincosamides (lincomycin and clindamycin) are contra-indicated in horses. Antimicrobial agents in these classes can cause severe disturbance of the balance between commensal bacterial flora in the colon of the horse. 

Clarithromycin is an H. pylori agent/macrolide, which inhibits microbial protein synthesis. Clarithromycin is indicated in the treatment of infections of the respiratory tract, skin and skin structure treatment of disseminated atypical mycobacterial infections caused by susceptible strains of specific microorganisms and prevention of disseminated Mycobacterium avium complex disease in patients with advanced HIV infection. Clarithromycin in combination with omeprazole is indicated in the treatment of patients with an active duodenal ulcer associated with H. pylori infection. In children it is used in acute otitis media. Macrolides are erythromycin, clarithromycin, and azithromycin. 

Wang, G., and Taylor, D. E. (1998). Site-specific mutations in the 23S rRNA gene of Helicobacter pylori confer two types of resistance to macrolide-lincosamide-streptogramin B antibiotics. Antimicrofe Agente Chemother. 42, 1952—1958. 

Cromwell O, Pepys J, Parish WE, Hughes EG (1979) Specific IgE antibodies to platinum salts in sensitized workers. Clin Allergy 9 109-117 Davies RJ, Pepys J (1975) Asthma due to inhaled chemical agents - the macrolide antibiotic spiramycin. Clin Allergy 5 99-108... 

The field of organic synthesis has seen equally rapid advances. The emphasis has been in the development of new stereoselective methods for achieving specific synthetic transformations. The exciting synthetic approaches in the field of macrolide antibiotics, anti-tumor agents and other biologically important natural products serve to exemplify these developments. 

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