Macrolides

Anti-Infectives

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Examples

azithromycinerythromycinclarithromycin

Prefix / Suffix: -thromycin

Physiology

Bacterial protein synthesis at the 50S ribosomal subunit is essential for growth.

Mechanism of Action

They bind the 50S ribosomal subunit, inhibiting bacterial protein synthesis (bacteriostatic).

Indications

Respiratory infections (atypical pneumonia)
Skin infections
STIs (chlamydia)
Penicillin-allergic patients

Side Effects / Adverse Effects

GI upset (nausea, vomiting, diarrhea — common)
QT prolongation (risk of arrhythmia)
Hepatotoxicity
Ototoxicity (high doses)

Contraindications

QT prolongation
Severe hepatic impairment
Concurrent use with other QT-prolonging drugs

Nursing Considerations

Take with food if GI upset (but azithromycin better on empty stomach)
Monitor ECG in at-risk patients (QT prolongation)
Monitor liver function (hepatotoxicity)
Many drug interactions — check before giving (CYP450 inhibition)
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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.