- Body system
- Anti-infectives
- Name stem
- -thromycin
- Drug cards
- 1 in this guide
Drugs in this class
Other examples: Clarithromycin, Erythromycin, Fidaxomicin.
How macrolides work
Bind the 50S ribosomal subunit and block protein synthesis (mostly bacteriostatic).
Uses
- Community-acquired pneumonia, including atypical organisms
- Pertussis
- Chlamydia
- H. pylori (clarithromycin)
- Penicillin-allergic patients
Adverse effects
- GI upset
- QT prolongation
- Liver injury
- Ototoxicity at high doses
- C. difficile
Nursing considerations
- Check the medication list for QT-prolonging drugs and CYP3A4 interactions (clarithromycin and erythromycin are strong inhibitors).
- Monitor liver function with longer courses.
Patient teaching
- Report palpitations or fainting.
- Finish the full course.
Macrolides NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
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Which ECG change is a concern with azithromycin?
Show answer
Answer D: Prolonged QT interval Macrolides can prolong the QT interval and cause torsades de pointes.
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Which macrolide is a strong CYP3A4 inhibitor with many drug interactions?
Show answer
Answer C: Clarithromycin Clarithromycin (and erythromycin) strongly inhibit CYP3A4; azithromycin has fewer interactions.
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A common indication for a macrolide is:
Show answer
Answer A: Atypical pneumonia Macrolides cover atypical organisms such as Mycoplasma and Chlamydophila.
Frequently asked questions
What are macrolides?
Macrolides treat respiratory infections, atypical pneumonia and chlamydia. QT prolongation and drug interactions (especially clarithromycin and erythromycin) are the key concerns.
How do macrolides work?
Bind the 50S ribosomal subunit and block protein synthesis (mostly bacteriostatic).
What are examples of macrolides?
Azithromycin, Clarithromycin, Erythromycin and Fidaxomicin.
What are the nursing considerations for macrolides?
Check the medication list for QT-prolonging drugs and CYP3A4 interactions (clarithromycin and erythromycin are strong inhibitors). Monitor liver function with longer courses.