MACROLIDE ANTIBIOTICS
Macrolide antibiotics are used to combat gram-positive and gram-negative
bacteria. As you’ll recall from microbiology, the gram stain is used as a method
to identify a bacteria. If after staining, the bacteria it appears purple, then the
bacteria are said to be gram positive. If it is pink, then the bacteria are gram-
negative. There is one exception: If the bacteria are either purple or pink, then a
macrobide antibiotic is effective against the bacteria.
The exception is with troleandomycin, which is a macrolide antibiotic.
Troleandomycin is used to fight Streptococcus pneumoniaeandStreptococcuus
pyogenes.
Macrolide antibiotics are bacteriostatic. That is, they inhibit reproduction of
bacteria, but do not kill the bacteria. By inhibiting reproduction, macrolide
antibiotics control the bacterial growth giving the body’s own immune system—
or other medication—time to kill the bacteria.
Prescribers give patients macrolide antibiotics to fight soft tissue infections,
skin infections, and infections of the respiratory and gastrointestinal tract.
Macrolides antibiotics have some side effects that adversely affect the patient.
The most common side effects are nausea, vomiting, stomach pain, and cramps.
These occur with azithromycin, clarithromycin, erythromycin, and dirithromycin.
Troleandomycin causes stomach cramps and discomfort.
Before administering macrolides, the patient is assessed using the same tech-
niques as described for other antibiotics. However, caution must be used when
prescribing macrolides to patients who have liver disease. Those with a history
of cardiac arrhythmias should not take erythromycin.
The patient should be advised to take macrolides with a full glass of water
either an hour before meals or two hours after meals to avoid gastric distress. Some(^222) CHAPTER 13 Antimicrobials—Fighting Infection
Fourth Generation: Cefipime same as third generation +
more resistant to b-lactamases
Pregnancy Category: B
Route Dose Time
Cefepine (Maxipime)
Protein-Binding: Unknown
Half-Life 0.5–2 hours
IM.IV 0.5–1 g Every 12 hours