Introduction to the macrolide antibiotics

Abstract

Macrolide antibiotics are an old and well-established class of antimicrobial agents that have long played a significant role in the chemotherapy of infectious diseases[1-3]. Among the most important characteristics of the macrolide class are a moderately broad spectrum of antimicrobial activity, an orally effective route of administration, and a relatively high margin of safety (high therapeutic index). Although macrolides have been the primary antibiotic of choice for a few indications, they have also played a very critical role as an alternative drug of choice, particularly as an alternative to the penicillins. Over the past two decades, the macrolide class has undergone a remarkable resurgence that has been characterized by 1) the discovery and commercial development of several important new semi-synthetic derivatives exhibiting a variety of improved features and 2) clinical efficacy in the treatment of several infectious diseases not originally associated with macrolide therapy. The subsequent chapters of this book will 1) document the clinical progress that has been made thus far in utilizing the more recent semi-synthetic macrolides, 2) update our knowledge and understanding about the biosynthetic origins of the macrolides and the mechanisms involved in their antibacterial activity and in microbial resistance to them, and 3) look toward the future emergence of additional new macrolides potentially arising from the discovery and development pipelines of several pharmaceutical research organizations.