Josamycin is an antibiotic that is effective against anaerobic Gram-positive bacterial strains. In Austria, it is usually called Josalid as an alternative. It is an alternative in cases of allergy to penicillin. However, hypersensitivity, cross-reaction, or side effects may also occur with the administration of Josamycin in some patients.
What is Josamycin?
Josamycin is an antibiotic that belongs to the macrolide group of drugs. It is both naturally derived from bacterial strains and synthetically produced. Josamycin is a 16-membered lactone ring that contains no amino sugars in the side chain.
Pharmacological effects on the body and organs
The mode of action of josamycin is that it binds to the ribosomes of pathogens and in this way blocks their protein synthesis. However, this does not apply to every pathogen. There are also pathogens that are resistant to josamycin. It is therefore important to clarify exactly which disease-causing bacterial strains Josamycin is to be given against when administering it to ensure that it can achieve the appropriate effect.
Medicinal use and use for treatment and prevention.
Josamycin is administered in an oral manner. Very often, it is given because patients are allergic to penicillin and a good effective alternative to this antibiotic is needed. Josamycin works very well on germs that are inside the cells and is well tolerated in most cases with some exceptions. The drug is helpful with many anaerobic strains of bacteria, with very many gram-positive, but equally gram-negative pathogens. Examples where the use of Josamycin has a good effect are Gram-positive cocci, rod bacteria such as Listeria or Corynebacteria, only partially also with Haemophilus as well as also with Gram-negative pathogens such as, among others, Mycoplasma, Campylobacter, Chlamydia, Bacteroides, Legionella, Bordatella and others. Therefore, the application of Josamycin includes chlamydial and mycoplasma infections, even during pregnancy. Josamycin can also be used for urethritis that does not have a gonorrheal origin. The drug is also helpful in many different infections, which include eye infections, upper respiratory tract infections, also lower respiratory tract infections, skin infections and soft tissue infections. It is important to note that Josamycin works especially well when a high tissue potency of the antibiotic is required. However, josamycin is not effective for enterobacteria, because these bacterial strains are resistant to the drug.
Risks and side effects
In general, Josamycin is one of those drugs that are very well tolerated and where risks and side effects are rather rare. However, it may also happen with this drug that it is not tolerated. Therefore, Josamycin is contraindicated in all hypersensitivity reactions, cross-reactions with other macrolide antibiotics, when the mother is breastfeeding or in infants under two months of age. Those who have liver damage are also very unlikely to tolerate Josamycin well and should clarify this very carefully with their treating physician. Similarly, administration of Josamycin is contraindicated in severe renal insufficiency. Side effects may present as allergic skin reactions, asthma, or pruritus. This is statistically the case in 0.4% of all applications. Mild gastrointestinal disturbances occur in up to 12% of applications. Discontinuation of therapy may also occur if side effects become too severe. Diarrhea, loss of appetite, vomiting, or nausea lead to discontinuation of therapy in 2% of all use cases. In 1% of therapy discontinuations, it is due to neurological disorders such as headaches and dizziness. Very rarely, discontinuation of therapy may also be necessary because cholestatic jaundice has occurred. Also very rarely, the drug is not tolerated because of colitis, tongue coating, stomatitis, or mucosal irritation. Interactions with other drugs occasionally occur, for example, when these drugs also stress liver metabolism.
