Lactone ring +1 or more deoxy-sugars.

All are effective against MRSA, Moraxella Catarrhalis, H Influenza

Mostly static

Mechanism:

inhibits translocation from A to P site

release peptidyl tRNA from ribosome (premature)

block formation of initiation complex (cant get protein off the ground)

• 1st drug effective against legionaires disease
• Metabolites complex with cytochrome heme Fe & inhibit CYP3A4 (isozyme that metabolizes erythromycin)
• Can prolong cardiac repolarization (Torsades de pointes) - be careful if used with another drug that inhibits CYP3A4
• Increased risk of sudden death
• Prokinetic - stimulates GI motility vs motilin receptors
  

concentrates intracellularly

Used for: community acquired pneumonia, legionaires disease, Mycobacterium avium complex

70hr 1/2-life. Does not inhibit P450 and is excreted unchanged in the bile

for community acquired pneumoni and mycobacterium avium complex

Inhibits transcription of mRNA for proinflammatory cytokines (IL8, NFKB, AP1)

Can cause very low blood sugar

Inhibits CYP3A

• a ketolide (macrolide derivative)
• increased G+ activity
• Same mechanism as macrolide but different domain (broader spectrum of activity)
• Use - community acquired infections
• Accumulates in pulmonary tissue, WBCs
• Active vs beta-lacatams & macrolide resistant bacteria
• Inhibits CYP3A4
• Prolongs Q-T interval
• BBW: dont use with myasthenia gravis