Which medications in the drug class Macrolides are used in the treatment of Toxoplasmosis?

Updated: Mar 08, 2019
  • Author: Murat Hökelek, MD, PhD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Macrolides

Spiramycin is a macrolide antibiotic with an antibacterial spectrum similar to erythromycin and clindamycin. It is bacteriostatic at serum concentrations but may be bactericidal at achievable tissue concentrations. The mechanism of action is unclear, but it acts on the 50S subunit of bacterial ribosomes and interferes with translocation. Absorption from the GI tract is irregular (20-50% of the oral dose is absorbed). Following oral administration, peak plasma levels are achieved within 2-4 hours. Spiramycin has a longer half-life than erythromycin and sustains higher tissue levels.

Azithromycin (Zithromax, Zmax)

Azithromycin acts by binding to the 50S ribosomal subunit of susceptible microorganisms, thereby interfering with microbial protein synthesis. Nucleic acid synthesis is not affected.

Azithromycin concentrates in phagocytes and fibroblasts, as demonstrated by in vitro incubation techniques. In vivo studies suggest that concentration of the drug in phagocytes contributes to drug distribution to inflamed tissues. Azithromycin treats mild to moderate microbial infections.

Spiramycin

This is the drug of choice for maternal or fetal toxoplasmosis. It is an alternative therapy in other patient populations when pyrimethamine and sulfadiazine cannot be used.


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