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The Toxicity of Macrolides Drug

Muralinath E., Mr. Vonteru Munisekhar, Dr. P. Prabhavathi, K. Suparnalatha, M. Harshita, Dr. G. Rajeswari, Sravani Pragna K., Guruprasad M.

Abstract


Toxic side effects from macrolide antibiotics include altered heart rhythm, liver damage, and upset stomach.

Overview of Macrolide Toxicity

  • Heart risks: Medications that lengthen QT intervals, such as azithromycin, erythromycin, and clarithromycin, may result in harmful arrhythmias such torsades de pointes.
  • Liver damage: Oral macrolides, especially erythromycin estolate, can result in acute cholestatic hepatitis or moderate enzyme increases.
  • Problems with the stomach and intestines: Direct stimulation of gut motility often results in diarrhea, nausea, vomiting, and abdominal pain.
  • Effects on the nervous system: Rare cases of neurotoxicity (such as visual hallucinations) and ototoxicity (hearing abnormalities) have been documented, particularly in kidney disease patients.

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References


Klein, J. O. (1997). History of macrolide use in pediatrics. The Pediatric Infectious Disease Journal, 16(4), 427–431.

Parnham, M. J., Erakovic Haber, V., Giamarellos-Bourboulis, E. J., Perletti, G., Verleden, G. M., & Vos, R. (2014). Azithromycin: Mechanisms of action and their relevance for clinical applications. Pharmacology & Therapeutics, 143(2), 225–245.

Yeo, Y. H., Shiu, S. I., Ho, H. J., Zou, B., Lin, J. T., Wu, M. S., Liou, J. M., Wu, C. Y., & Taiwan Gastrointestinal Disease and Helicobacter Consortium. (2018). First-line Helicobacter pylori eradication therapies in countries with high and low clarithromycin resistance: A systematic review and network meta-analysis. Gut, 67(1), 20–27.

Farzam, K., Nessel, T. A., & Quick, J. (2023). Erythromycin. In StatPearls. StatPearls Publishing.

Cunha, B. A. (2006). The atypical pneumonias: Clinical diagnosis and importance. Clinical Microbiology and Infection, 12(Suppl. 3), 12–24.

Gao, Y. H., Guan, W. J., Xu, G., Tang, Y., Gao, Y., Lin, Z. Y., Lin, Z. M., Zhong, N. S., & Chen, R. C. (2014). Macrolide therapy in adults and children with non-cystic fibrosis bronchiectasis: A systematic review and meta-analysis. PLOS ONE, 9(3), Article e90047.

Qiu, S., & Zhong, X. (2017). Macrolides: A promising pharmacologic therapy for chronic obstructive pulmonary disease. Therapeutic Advances in Respiratory Disease, 11(3), 147–155.

Vázquez-Laslop, N., & Mankin, A. S. (2018). How macrolide antibiotics work. Trends in Biochemical Sciences, 43(9), 668–684.

Munita, J. M., & Arias, C. A. (2016). Mechanisms of antibiotic resistance. Microbiology Spectrum, 4(2).

Marosevic, D., Kaevska, M., & Jaglic, Z. (2017). Resistance to the tetracyclines and macrolide-lincosamide-streptogramin group of antibiotics and its genetic linkage: A review. Annals of Agricultural and Environmental Medicine, 24(2), 338–344.

Carter, B. L., Woodhead, J. C., Cole, K. J., & Milavetz, G. (1987). Gastrointestinal side effects with erythromycin preparations. Drug Intelligence & Clinical Pharmacy, 21(9), 734–738.

Albert, R. K., Schuller, J. L., & COPD Clinical Research Network. (2014). Macrolide antibiotics and the risk of cardiac arrhythmias. American Journal of Respiratory and Critical Care Medicine, 189(10), 1173–1180.

Ikeda, A. K., Prince, A. A., Chen, J. X., Lieu, J. E. C., & Shin, J. J. (2018). Macrolide-associated sensorineural hearing loss: A systematic review. The Laryngoscope, 128(1), 228–236.

Williams, D. A. (2000). Stevens-Johnson syndrome after erythromycin therapy while deployed at sea. Military Medicine, 165(8), 636–637.

Berger, F. A., van Weteringen, W., van der Sijs, H., Hunfeld, N. G. M., Bunge, J. J. H., de Groot, N. M. S., van den Bemt, P. M. L. A., & van Gelder, T. (2021). Dynamics of the QTc interval over a 24-h dose interval after start of intravenous ciprofloxacin or low-dose erythromycin administration in ICU patients. Pharmacology Research & Perspectives, 9(6), Article e00865.

von Rosenstiel, N. A., & Adam, D. (1995). Macrolide antibacterials: Drug interactions of clinical significance. Drug Safety, 13(2), 105–122.


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