MACROLIDES - RENEWED INTEREST AND PERSPEC TIVES

A complex family: Macrolides form a complex chemical family, differing by their lactone structure. The most widely used compounds have a lac tone cycle composed of 14 to 16 units. 14-unit macrolides can be divid ed into naturally occuring compounds such as erythromycin A or oleandr omycin and semi-synthetic macrolides based on erythromycin A. Problems with erythromycin: The leading compound in this family, erythromycin is the most active natural derivative. It has the disadvantage of bein g bacteriostatic with a slow bactericidal action. Use hase declined be cause it is unstable in acid medium. Renewed interest: The discovery o f community acuired L. pneumophilia pneumonia has led to renewed inter est in macrolides. Semi-synthetic compounds such as the leading compou nd, roxithromycin, are stable in acid medium and have interesting phar macokinetic properties, favoring more widespread used.