NEW MACROLIDES

Introduction. - Following their use for a few years, the place of new macrolides can be assessed Current knowledge and key points. - ''New m acrolides'', ie, roxithromycin, clarithromycin, azithromycin and dirit hromycin, are derivated from erythromycin and destined by different ph armacokinetic parameters: longer half time with better oval administra tion and shorter duration of treatment, better tissue concentrations w ith reduction of dosages and better tolerance, high cellular concentra tion with good activity However, new macrolides and erythromycin do no t show major differences in their antibacterial spectrum against usual pyogenic strains. Clinical use of new macrolides extends to opportuni stic infections, such as atypical mycobacterial infections or toxoplas mosis, occurring in the course of HIV infection. New macrolides are al so recommended for the treatment of Helicobacter pylori-related gastro duodenal ulcer. Future prospects and projects, - New macrolides have o pened new avenues in the development of anti-infectious strategies. Du e to their good efficacy against Chlamydia pneumoniae which is suspect ed of inducing vascular diseases, the upcoming use of ketolids and the development of their non-antibiotic effects, the future of macrolides is favorable. (C) 1998 Elsevier, Paris.