Introduction
Macrolides are antibiotics that are mainly effective against intracellular bacteria, i.e. bacteria that infiltrate various body cells. Macrolides can be used against various pathogens against which, for example, penicillins and cephalosporins are not effective. The effect of the macrolides is based on the fact that they inhibit the reproduction of the bacteria (bacteriostatic) and thus stop the spread of the bacterial infection.
Indications for macrolides
Indications for therapy with macrolides are (as with all other antibiotics) infections with bacterial pathogens. As a class of antibiotics, macrolides are particularly effective against bacteria that “hide” in the body’s own cells. Thus, macrolides can be used particularly well against bacteria from the group of Chlamydia or mycoplasma.
Chlamydiae are bacteria that primarily cause infections of the reproductive organs. Mycoplasmas, on the other hand, like to settle in the respiratory tract. Macrolides also act against so-called gram-negative bacteria.
These are bacteria that cannot be stained with a special staining method (Gram staining). They include bacteria such as legionella (which typically causes pneumonia) and neisseria (typical pathogens of venereal diseases and meningitis). But also Gram-positive bacteria (which can be stained in the Gram stain) such as streptococci can be treated with macrolides.
Streptococci, for example, can cause tonsillitis in the context of scarlet fever or soft tissue inflammation, middle ear inflammation and meningitis. This makes the macrolides a group of antibiotics that are effective against a variety of bacterial infections. Overall, macrolides are suitable against almost all diseases of the respiratory tract.
They are also used against many venereal diseases and bacterial skin diseases. It is important to note that enterobacteria (which are mainly found in the digestive tract) cannot be treated with macrolides. Therefore macrolides are not suitable for the treatment of urinary tract infections and cystitis.
Active ingredient and effect
The effect of macrolides is based on an inhibition in the formation of various proteins of the bacteria. For the formation of these bacterial proteins, so-called ribosomes are required. These are large structures on which the translation of the genetic material of the bacteria takes place.
The macrolides attach themselves to the ribosomes and thus prevent other substances required for the translation of this genetic material from docking to the ribosomes. This stops the formation of proteins in the bacteria. The bacteria cannot reproduce their genetic material and cell growth comes to a standstill.
In addition, new bacteria can no longer develop. Through this mechanism, macrolide therapy can be used to treat bacterial infections. The active ingredients used are erythromycin, azithromycin, clarithromycin and rocithromycin.
