Abstract
Clarithromycin and azithromycin, which are more acid-stable than erythromycin A (EM), have been widely prescribed for the treatment of respiratory tract infections because of their high efficacy and safety. However, these macrolide antibiotics are only weakly active against pathogens with an efflux gene (mef) and are inactive against pathogens with a methyltransferase-inducible gene (erm) and constitutively resistant organisms. To address the drug resistance issue, tremendous efforts have been devoted to the modification of the macrolide structure. As a consequence, several types of decladinosyl derivatives, such as ketolide and acylides, have been recognized to be effective against meftype resistant streptococci and methylase-inducible staphylococci. It has also been recognized that derivatives containing certain 11-, 6- or 4”-tethered aryl substituents, such as telithromycin (HMR 3647), cethromycin (ABT-773) and CP- 544372, are effective against erm(B)-type resistant streptococci. Telithromycin was recently approved in several European countries for the treatment of respiratory tract infections and cethromycin is now in the final stage of clinical study. Macrolide antibiotics have been modified to address the issues of acid-instability and inactivity against resistant strains. In this review, we will summarize the progress in the macrolide research area and discuss the desirable features of the next generation macrolide antibiotics.
Keywords: Macrolide Antimicrobial, cethromycin, methylase-inducible, meftype
Current Topics in Medicinal Chemistry
Title: Recent Developments in Macrolide Antimicrobial Research
Volume: 3 Issue: 9
Author(s): Toshifumi Asaka, Akira Manaka and Hiroyuki Sugiyama
Affiliation:
Keywords: Macrolide Antimicrobial, cethromycin, methylase-inducible, meftype
Abstract: Clarithromycin and azithromycin, which are more acid-stable than erythromycin A (EM), have been widely prescribed for the treatment of respiratory tract infections because of their high efficacy and safety. However, these macrolide antibiotics are only weakly active against pathogens with an efflux gene (mef) and are inactive against pathogens with a methyltransferase-inducible gene (erm) and constitutively resistant organisms. To address the drug resistance issue, tremendous efforts have been devoted to the modification of the macrolide structure. As a consequence, several types of decladinosyl derivatives, such as ketolide and acylides, have been recognized to be effective against meftype resistant streptococci and methylase-inducible staphylococci. It has also been recognized that derivatives containing certain 11-, 6- or 4”-tethered aryl substituents, such as telithromycin (HMR 3647), cethromycin (ABT-773) and CP- 544372, are effective against erm(B)-type resistant streptococci. Telithromycin was recently approved in several European countries for the treatment of respiratory tract infections and cethromycin is now in the final stage of clinical study. Macrolide antibiotics have been modified to address the issues of acid-instability and inactivity against resistant strains. In this review, we will summarize the progress in the macrolide research area and discuss the desirable features of the next generation macrolide antibiotics.
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Cite this article as:
Asaka Toshifumi, Manaka Akira and Sugiyama Hiroyuki, Recent Developments in Macrolide Antimicrobial Research, Current Topics in Medicinal Chemistry 2003; 3 (9) . https://dx.doi.org/10.2174/1568026033452140
DOI https://dx.doi.org/10.2174/1568026033452140 |
Print ISSN 1568-0266 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4294 |
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