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The Side Effects of Macrolides

Macrolides are a class of antibiotic agents used to treat various causes of infection. Macrolides have activity against Staphylococcus, the organism typically responsible for skin and soft tissue infection. Macrolides also exhibit activity against upper and lower respiratory pathogens such as Streptococcus, Haemophilus, Mycoplasm, Moraxella and Bordetella. Chlamydia and Neisseria, organisms associated with certain sexually transmitted diseases, will also respond to macrolide therapy. Macrolides may also be used in combination regimens to treat peptic ulcer disease and certain opportunistic infections in patients with HIV.

  1. Mechanism of Action

    • Macrolide antibiotics interfere with the genetic make-up of susceptible bacteria by inhibiting a crucial step in strain development and reproduction.

    Side Effects

    • The most common side effect of macrolide antibiotics is stomach upset. Nausea, vomiting, diarrhea, heartburn and indigestion occur in up to 10 percent of patients. Taste disturbances and mild abdominal pain have also been noted. Rash, headache, weakness and changes in liver function or elevation of liver enzymes occur less often.

    Allergic Reaction

    • As with any medication, allergic reaction may occur. Allergy symptoms may include rash, itching, difficultly breathing or swallowing, and swelling---in particular swollen lips, face or tongue. Patients who experience any symptom of potential allergic reaction should notify a physician or seek medical attention immediately.

    Special Precautions

    • Macrolide antibiotics may interact with other medications patients are taking, especially blood thinners, cardiac agents, oral contraceptives or antifungals. These interactions may cause abnormal heart rhythms, result in higher than desired drug levels or affect the activity of other medications. Patients who are prescribed a macrolide antibiotic should consult their physician or pharmacist to be certain it is safe to take along with their other medications.

    Available Products

    • As of 2009, three major macrolide products are approved for use by the U.S. Food and Drug Administration and available on the U.S. market. Azithromycin, or Zithromax, is used most commonly. According to Pharmacy Times Magazine, azithromycin ranks among the top 200 drugs dispensed each year. Clarithromycin, or Biaxin, and erythromycin, the oldest of the three, are used less often due to increased side effects. All three agents are currently available in generic form.

    Expert Insight

    • Taking macrolide antibiotics with a full glass of water and a meal or snack may help decrease stomach upset. Women who are using oral contraceptives may wish to employ an additional method of birth control during the menstrual cycle surrounding treatment. Taste disturbances may be controlled with hard candies, mints or gum. Continue the full course of antibiotic treatment as directed by a physician even if symptoms have subsided. This helps prevent the development of bacterial resistance to antibiotic agents.

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