#macrolide

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(via Macrolide Antibiotics - Azithromycin vs Clarithromycin vs Erythromycin)

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Azithromycin

Common Brand Names: Zithromax

Therapeutic Class: A semisynthetic macrolide antibiotic

Common Injectable Dosage Forms:

Powder for Injection: 500 mg in 10 mL vials

Dosage Ranges:

The usual dose for community-acquired pneumonia is 500 mg IV as a single daily dose for 2 or more days followed by oral therapy of 500 mg/day for a total of 7-10 days.

The usual dose for treatment of pelvic inflammatory disease caused by Neisseria gonorrhoeae, Chlamydia trachomatis, or Mycoplasma hominis is 500 mg IV for 1-2 days followed by oral therapy of 250 mg/day for a total of 7 days.

Administration and Stability: Injections should be administered IV over a short period of at least 60 minutes. Do not inject by IM route or as bolus IV. Reconstituted solution is stable for 24 hours at room temperature or 7 days when stored under refrigeration. Mix with compatible diluents to a final concentration of 1 mg/mL or 2 mg/mL. Compatible diluents include Normal Saline (NS), ½ NS, Lactated Ringer’s Solution, 5% Dextrose, 5% Dextrose in ½ NS, 5% Dextrose in 1/3 NS, 5% Dextrose in ½ NS with 20 mEq KCl, 5% Dextrose in Lactated Ringer’s Solution. pH: 6.4-66

Pharmacology/Pharmacokinetics: Azithromycin binds to the 50S ribosomal subunit of susceptible bacteria thereby suppressing protein synthesis. Distribution occurs to most body tissues except CSF and aqueous humor of the eye. Excretion occurs primarily through the bile as unchanged drug. The long half-life is 68 hours may be due to extensive tissue uptake and slow release of drug from tissues.

Drug and Lab Interactions: Use with caution in patients on cyclosporine. May increase risk of severe myopathy or rhabdomyolysis in patients taking HMG-CoA reductase inhibitors. May cause QT prolongation when coadministered with amiodarone.

Contraindications/Precautions: Contraindicated in patients with a history of hypersensitivity to macrolides. Use caution in patients with impaired hepatic function. Use with caution in those with QT prolongation. Pseudomembranous colitis and secondary bacterial infections may occur with broad-spectrum antibiotics; contact physician if diarrhea becomes severe or persistent. Do not use for complicated pneumonia, gonorrhea, or syphilis. Pregnancy Category B.

Monitoring Parameters: LFTs

Adverse Effects: The most common adverse effects include DIARRHEA (4.3%), nausea (3.9%), vomiting (1.4%), and abdominal pain (2.7%). Intravenous therapy may cause pain at the injection site (6.5%) and local inflammation (3.1%). Rare cases of angioedema and anaphylaxis have occurred.

Common Clinical Applications: Effective for initial treatment of community-acquired pneumonia and pelvic inflammatory disease. Effective against the following organisms: Chlamydia pneumoniae, Streptococcus pneumoniae, Haemophilus influenzae, Legionella pneumoniae, Moraxella catarrhalis, Staphylococcus aureus, Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma hominis.

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Le virus filmé pour la première fois

Le virus filmé pour la première fois

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Des macrolides en traitement du Covid19 ?

Trois médecins ont essayé un traitement à base d'azithromycine en suivant leur flair empirique. L'axe central tourne autour de l'azithromycine avec l'appui du zinc, ce qui est un classique car ce métal est connu pour renforcer les propriétés antibactériennes d'une substance antibiotique...

https://drive.google.com/open?id=1K6rJVrsGl4GYlJxt6upFpacyYRn3Vddy

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Lorraine. Un médecin mosellan constate l’efficacité d’un protocole à base d’azithromycine

Deux médecins mosellans et l’une de leurs consœurs belges semblent avoir mis au point une combinaison médicamenteuse efficace contre le coronavirus. ...

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Macrolide

In this article, we will discuss about Macrolide. So, let’s gets started.

Definition

Macrolide is a class of antibiotic which are effective against Gram-positive bacteria (excluding enterococci) and limited Gram-negative bacteria, it is also effective against Mycoplasma pneumoniae, Treponema pallidum, Campylobacter spp., Bordella pertusis, Chlamydia trachomatis, Legionella spp., Borella spp.,…

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Syphilis!

Syphilis is caused by Treponema pallidum. This is a spirochaete, with a low reflective index, and it is motile using its spiral shape to propel itself (it has internal flagella attached to the cytoplasmic membrane). It is too thin to visualise with gram staining, but it can be viewed using dark-field, electron, Steiner silver stain and fase-contrast methods.

Treponema palladium can also cause Yaws (burrows under the skin), Pinta (hyperkeratosis) and Bejel (much more like syphilis, but not an STI; spread using same cooking utensils). 

There are 3 stages of syphilis:

Primary: Chancre: immune response causes tissue degradation without pain, which eventually disappears. 

Secondary: 6-8 weeks after infection, patients present with generalised malaise and rashes, even palmar rashes. This is systemic.

Tertiary: after 3-30 years of a latent period, symptoms can reappear, including gummas across body/tongue (do not contain many bacteria cells, mainly an immune response), cardiovascular/meningovascular lesions (leading to aneurisms/strokes), and ‘general paresis of the insane’, aka neurosyphilis (hypersensitivity in the brain).

Lesions from syphilis often allow secondary infections to occur, such as S. aureus. 

Spread:

Syphilis spreads HORIZONTALLY as an STI or via contaminated blood. It spreads VERTICALLY as congenital syphilis. 

Congenital syphilis is typified with Hutchinson’s teeth, Sabre teeth, bone lesions and neurosyphilis; however it can present anywhere between 5-25 years old. The mother should be treated prophylactically if there is a risk.

Diagnosis:

Using exudate/biopsy from chancre. 

Using serology to identify reagin, an antibody produced during body damage, using VDRL/RPR testing. FTA serology finds antibodies specific to T. pallidum. These tests rely on antigen and antibody complexes binding to an anti-human antibody which is conjugated to a fluorophor at the FAB region for visualisation.

It is found highest between the ages of 20-40, and is higher in men: 9:1. It mostly affects men who have sex with men. Education around HIV and AIDS also decreased the incidence.

Treatment:

Benzylpenicillin or a macrolide (bacteriostatic, such as the new azithromycin) are used to block the peptide exit tunnel of T. pallidum’s 50S ribosomal subunit.

Old treatments: Mercury, salvarsan, malaria (increases temperature beyond limits of the bacteria), and penicillin. 

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Bryostatin 1 - is a macrolide isolated from the bryozoan marine organism, Bugula neritina, and is a potent modulator of protein kinase C (PKC). It has been investigated for the treatment of cancer and AIDS/HIV. There is some evidence that it improves cognition and ability activities in patients with moderate to severe Alzheimer’s disease.