You probably go to the doctor when you have a fever, a cough, or some other infection and they give you an antibiotic, right? One special class of these antibiotics is called 'Macrolides'. You may have been given a medicine with this name before. So today, let's talk about what these macrolides are, what diseases they are used to treat, and what we need to be aware of when using them.
What are these macrolides?
Simply put, macrolides are a class of antibiotics. Their main function is to stop the growth of bacteria that have entered our bodies. To be precise, these drugs work by inhibiting the activity of bacteria so that they cannot spread or grow further.
But there is something very important that we all need to understand here. Macrolide antibiotics only work against bacterial infections. They do not cure viral infections like the common cold and flu.
Also, some people may be allergic to other antibiotics, such as penicillin. In such cases, doctors prescribe macrolides as an alternative.
What are the most commonly used macrolides?
There are several types of macrolides that are commonly prescribed by doctors in Sri Lanka and around the world. You may be familiar with one of these names.
| Drug Name | A brief introduction |
|---|---|
| Azithromycin | This is a type of macrolide that many people have heard of and is commonly used. |
| Clarithromycin | It is used to treat various infections, including bacteria that cause stomach ulcers. |
| Erythromycin | An older type of macrolide that comes in the form of tablets as well as a cream (gel) applied to the skin. |
| Fidaxomicin | It is used especially for C. diff infection, a severe infection of the intestines. |
What conditions are macrolides used for?
These medications are used to treat a wide range of bacterial infections. Here are some examples:
- Atypical pneumonia: A special type of pneumonia, also known as "walking pneumonia."
- Bacterial eye infections: Infections that cause symptoms such as redness and watery eyes.
- Skin infections: For conditions like acne, a gel containing Erythromycin is sometimes prescribed to control bacteria on the skin.
- Strep throat: Especially in those who are allergic to penicillin.
- Whooping cough/Pertussis: An infection that causes a severe, long-lasting cough.
- H. pylori infection: This is a bacteria that is a major cause of stomach ulcers. It is treated with medications such as `(Clarithromycin)` in combination with other medications.
- Sexually transmitted infections: For infections like Chlamydia.
- Other infections: They are also used to treat infections caused by cat scratches (Cat scratch fever), diphtheria, and traveler's diarrhea.
How are these medications used and for how long?
Macrolide antibiotics come in different forms.
- Swallowed pills
- Liquids
- Gels or solutions applied to the skin
- Ointments
- Injections given by a doctor
The most important thing is to take the medicine exactly as your doctor tells you to, in the prescribed dose, and for the prescribed number of days. Especially if it's a liquid medicine, use only the measuring device that comes with it. Measuring with teaspoons at home won't give you the exact dose.
Even if you feel better, you should take the medicine for the full number of days prescribed by the doctor. Otherwise, the disease may not be completely cured, and some bacteria may remain in the body, causing the disease to recur. Therefore, it is essential to complete the course of medicine.
Do macrolides have side effects?
Like any antibiotic, macrolides can cause minor side effects. The most common is stomach upset.
- Nausea and vomiting
- Stomach ache or pain
- Diarrhea
These side effects are usually not serious. However, their nature may vary depending on the type of macrolide you are taking. Your doctor will inform you about this.
Additionally, macrolides can interact with other medications you are taking. So, be sure to tell your doctor about all the medications, vitamins, and supplements you are taking. Also, tell your doctor if you drink alcohol. Sometimes you may need to avoid alcohol while taking this medication.
Although rare, some people may experience allergic reactions. The most common symptom is a skin rash. Very rarely, severe skin conditions such as Stevens-Johnson syndrome can occur.
Can heart rate changes (arrhythmias) occur?
This is also very rare, but important to be aware of. Some macrolides have a very small risk of causing abnormal heart rhythms (arrhythmias). This is because these medications can prolong something called the QT interval. Simply put, it takes a little longer for the heart muscle to contract and then relax. This can cause a dangerous heart rhythm called Torsades de Pointes.
If you have a heart condition, the doctor will take that into account and prescribe a different antibiotic if necessary.
When do you need to see the doctor?
It is very important to talk to your doctor in the following situations.
| Opportunity | Description |
|---|---|
| In such a situation, talk to the doctor. | |
| Questions about how to take medication | If you are not clear about things like dosage and timing. |
| Discomfort due to side effects | If it is too difficult to take the medicine due to things like nausea and vomiting. |
| No reduction in symptoms | If your illness has not been cured even after completing the course of medication. |
| Allergy symptoms | If something like a skin rash appears. |
| In such a situation, go to the hospital's Emergency Treatment Unit (ETU) immediately. | |
| Severe diarrhea | If you have watery diarrhea several times a day or if you have signs of dehydration. |
| Severe allergy | If you experience symptoms of anaphylaxis, such as difficulty breathing and facial swelling, this is a serious emergency. |
Take-Home Message
- Macrolides are a type of antibiotic given to treat bacterial infections . They do not work against viral infections like the common cold.
- Take the full amount of medication prescribed by your doctor, for the full number of days . Do not stop taking it halfway.
- Inform your doctor about all other medications you are taking and any other medical conditions you have (especially heart disease).
- Minor side effects such as stomach upset may occur, but if you experience severe diarrhea, skin rashes, or difficulty breathing , seek medical advice immediately.
- If you develop severe allergic symptoms or dehydration that require immediate treatment, go to the Emergency Department (ETU) of the nearest hospital.
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