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Resistance to Macrolides, Lincosamides, and Streptogramins

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Antimicrobial Drug Resistance

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Abstract

The structurally unrelated antimicrobials, macrolides, lincosamides, and streptogramins are grouped into a single family, called MLS family. This classification is based on a similar, although not identical, mechanism of action. Macrolides are composed of a minimum of two amino and/or neutral sugars attached to a lactone ring of variable size [1] (Fig. 18.1). Erythromycin, produced by a strain of the actinomycete Saccharopolyspora erythraea (formerly Streptomyces erythraeus), is the first macrolide discovered in 1952. It actually corresponds to a mixture of antibiotics that includes erythromycin A, which is the active compound and has a 14-membered lactone ring with two sugars, cladinose and an amino sugar (e.g., desosamine). Other commercially available macrolides derived from erythromycin A include clarithromycin, dirithromycin, roxithromycin, as well as azithromycin that has an enlarged 15-membered ring resulting from a nitrogen insertion. Structural modifications of erythromycin A resulted in improved pharmacokinetic profiles and better tolerance, but cross-resistance between members of this class of antimicrobials was still observed. Some 16-membered ring macrolides are also available in a few countries (spiramycin, josamycin, midecamycin, and miocamycin) or for veterinary use (tylosin). The most recent class of ketolides comprises telithromycin and cethromycin (ABT-773), which are derived from clarithromycin and have two major modifications, replacement of cladinose by a keto-function and an 11-12-carbamate extension with an alkyl-aryl modification in telithromycin. The first fluoroketolide solithromycin (CEM-101), exhibiting a different side chain and a fluorine atom linked to C-2 of the lactone, shows higher in vitro activity and enhanced accumulation in macrophages as compared to telithromycin [2].

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Authors and Affiliations

  1. Department of Clinical Microbiology, School of Medicine, Caen University Hospital, University of Caen Normandie, Caen, France

    Vincent Cattoir Pharm.D., Ph.D. & Roland Leclercq M.D., Ph.D.

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  1. Vincent Cattoir Pharm.D., Ph.D.
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  2. Roland Leclercq M.D., Ph.D.
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Correspondence to Vincent Cattoir Pharm.D., Ph.D. .

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Editors and Affiliations

  1. Treiber Therapeutics, Cambridge, Massachusetts, USA

    Douglas L. Mayers

  2. Wayne State University School of Medicine, Detroit Medical Center, Detroit, Michigan, USA

    Jack D. Sobel

  3. Centre de recherche en Infectiologie, University of Laval, Quebec City, Canada

    Marc Ouellette

  4. Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA

    Keith S. Kaye

  5. Infection Control and Prevention Unit of Infectious Diseases, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel

    Dror Marchaim

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Cattoir, V., Leclercq, R. (2017). Resistance to Macrolides, Lincosamides, and Streptogramins. In: Mayers, D., Sobel, J., Ouellette, M., Kaye, K., Marchaim, D. (eds) Antimicrobial Drug Resistance. Springer, Cham. https://doi.org/10.1007/978-3-319-46718-4_18

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