Mechanism of action of macrolides: azithromycin, clarithromycin and erythromycin

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Author:
Gary Kaiser
Biology Department
The Community College of Baltimore County, Catonsville Campus
Baltimore, MD 21228
USA
Email: gkaiser@ccbcmd.edu

From Richard Harvey (series editor), Lippincott’s Illustrated Reviews: Pharmacology (LWW, 2008):

“Macrolides mechanism of action (MOA)

The macrolides bind irreversibly to a site on the 50S subunit of the bacterial ribosome, thus inhibiting the translocation steps of protein synthesis . They may also interfere at other steps, such as transpeptidation. Generally considered to be bacteriostatic, they may be bactericidal at higher doses. Their binding site is either identical or in close proximity to that for clindamycin and chloramphenicol.”

Common antibiotic macrolides:

Azithromycin (Zithromax, Zitromax, Sumamed) – Unique, does not inhibit CYP3A4
Clarithromycin (Biaxin)
Dirithromycin (Dynabac)
Erythromycin
Roxithromycin (Rulid, Surlid,Roxid)
Tulathromycin

Protein synthesis inhibitors: macrolides mechanism of action animation. Classification of agents

Further reading