Abstract
Macrolides are broad-spectrum, versatile antibiotics. Among the newer macrolides, azithromycin and clarithromycin have gained wide use because of their less frequent dosing schedules and somewhat better tolerability. Erythromycin has a niche in clinical practice as an alternative in β-lactam-allergic patients and is a drug of choice in pertussis, mycoplasmal, chlamydial, and Legionella infections. Azithromycin and clarithromycin are more expensive altermates to erythromycin, with pharmacokinetic advantages such as a long half-life and high tissue concentration and somewhat broader spectra of activity. These attributes may not produce superior efficacy to erythromycin in the treatment of infections for which erythromycin is indicated. However, both drugs have excellent activity against mycobacteria, which has dramatically improved the outcome of mycobacterial infections in AIDS patients.
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