Recent semi-synthetic studies of erythromycin A culminated in the discovery
of two ketolide drug candidates, HMR-3647 and ABT-773, for the treatment o
f community-acquired bacterial infections caused by both macrolide- and bet
a -lactam-susceptible and -resistant S. pneumoniae, gram negative bacteria,
and intracellular atypical pathogens. The discovery of ketolides has rekin
dled interest in macrolides, and recent efforts have also led to a novel cl
ass of 4 " -carbamates with activity against macrolide-resistant organisms.
This review is an account of recent developments on ketolides and macrolid
es in terms of both chemistry and antibacterial activity.