Roxithromycin: Effects, Uses & Risks

The drug roxithromycin belongs to the macrolide antibiotics. It is used to treat various bacterial infections.

What is roxithromycin?

Roxithromycin is used as an antibiotic to fight bacterial infections. These primarily include diseases of the upper respiratory tract. Roxithromycin belongs to the glycoside group and is a macrolide. Macrolide antibiotics are similar to penicillin in their effect and are considered to be well tolerated. For this reason, they are an excellent alternative in the case of penicillin allergy. Furthermore, macrolides are frequently used in pediatrics. Roxithromycin was developed in the 1980s by the German pharmaceutical company Hoechst AG. The active ingredient was considered a further development of the macrolide antibiotic erythromycin. Due to chemical changes, roxithromycin shows fewer interactions and is more broadly effective against bacteria than other antibiotics. The macrolide came onto the market in 1987, and various generics were launched after patent protection ended. Roxithromycin can be obtained at pharmacies but is subject to prescription.

Pharmacologic effects on the body and organs

Just like the cells of humans and animals, the cells of bacteria are also equipped with genetic material. This DNA acts as a blueprint for the proteins by which numerous important activities are carried out within the cell. Roxithromycin has the property of having an inhibitory effect on ribosomes. These are cell complexes in which DNA is translated into proteins. This process stops the growth and reproduction of the bacteria. There are major differences between the ribosomes of bacteria and humans. This has the advantage that the bacteria can be precisely eliminated by roxithromycin. In addition, the macrolide antibiotic causes relatively few side effects. Once the patient has taken the roxithromycin, two-thirds of the active substance enters the blood via the intestine. After two hours, the peak level of the antibiotic occurs in the organism. The skin, lungs and urinary tract are particularly sensitive to roxithromycin. In addition, the drug can accumulate in immune cells. Via the bloodstream, these reach the bacterial infection site.

Medical application and use for treatment and prevention.

Roxithromycin is administered against various bacterial infections as well as against diseases for which streptococci are responsible. These are primarily diseases of the respiratory tract or ear, nose, and throat region, such as tonsillitis, inflammation of the throat, colds associated with mucus, whooping cough, acute or chronic bronchitis, and pneumonia. Roxithromycin can also be administered to treat inflammation of the urinary bladder or vagina caused by bacterial species such as mycoplasma or chlamydia. The macrolide antibiotic is also suitable for the treatment of soft tissue inflammations or skin infections. These include erysipelas, impetigo contagiosa (impetigo), hair follicle inflammation, or pyogenic rash. Roxithromycin is taken in tablet form. Dosage and duration of treatment depend on the type and extent of the disease. The sensitivity of the germ also plays an important role. The usual dose is two times 150 milligrams of roxithromycin per day. The patient takes this every 12 hours before eating, so that the total daily dose is 300 milligrams. Children weighing less than 40 kilograms and patients with liver impairment are given a smaller amount. The intake of roxithromycin is subject to a time limit and usually lasts from 5 to 14 days. The treatment must be stopped completely. This is true even if symptoms subside, otherwise there is a risk of relapse of the disease.

Risks and side effects

Adverse side effects from taking roxithromycin occur in 1 to 10 out of 100 patients. These include mainly headache, dizziness, nausea, vomiting, diarrhea, stomach pain, and swelling and redness of the skin. One in one hundred patients also suffers from itchy skin rashes, hypersensitivity reactions or an increase in leukocytes (the white blood cells).Because positive-acting bacteria are also killed by roxithromycin, there is occasionally a risk of superinfection with yeasts. This occurs primarily in the mucous membrane of the mouth or vagina. Destruction of the bacteria makes it easier for the fungus to spread. Other rare side effects include swelling of the joints, tongue or larynx, fever, hives, weakness, breathing problems, tinnitus, bile stasis, jaundice, odor disorders, taste disorders, inflammation of the pancreas, cramps or Stevens-Johnson syndrome. In the worst case, life-threatening anaphylactic shock is possible. Roxithromycin should not be used at all if the patient suffers from hypersensitivity to the active substance or other macrolide antibiotics. The drug is also not suitable for children weighing less than 40 kilograms. In addition, care should be taken not to take roxithromycin together with dihydroergotamine or ergotamine. There is a risk of severe constriction of the blood vessels. Furthermore, there is a risk of life-threatening cardiac arrhythmias if the macrolide is administered together with astemizole, pimozide, terfenadine and cisapride. Roxithromycin is also not suitable for people with low blood magnesium or potassium levels. They are also at risk of cardiac arrhythmias. Careful weighing of the risks and benefits of roxithromycin is required in the case of liver dysfunction. The same applies to the use of the macrolide during pregnancy and lactation. Thus, the safety of the drug in these phases could not be demonstrated. In addition, roxithromycin can pass into breast milk, transferring the antibiotic to the baby.