Mechanism of action
Mechanism of resistance
- Post-transcriptional methylation of the 23S bacterial ribosomal RNA
- Gastrointestinal side-effects are common. Nausea is less common with clarithromycin than erythromycin
- Cholestatic jaundice: risk may be reduced if erythromycin stearate is used
- P450 inhibitor
- Statins should be stopped whilst taking a course of macrolides. Macrolides inhibit the cytochrome P450 isoenzyme CYP3A4 that metabolises statins. Taking macrolides concurrently with statins significantly increases the risk of myopathy and rhabdomyolysis.