Which medications in the drug class Macrolides are used in the treatment of Lyme Disease?
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Which medications in the drug class Macrolides are used in the treatment of Lyme Disease?
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@bernyc Macrolides
Macrolides are second-line agents for treatment of Lyme disease. They are appropriate only for patients with intolerance or contraindications to the use of tetracycline and beta-lactam antibiotics.Erythromycin ethylsuccinate (E.E.S., EryPed, PCE, Erythrocin)
Use of erythromycin should be limited to patients who cannot take tetracyclines or beta-lactam antibiotics, as erythromycin is inferior to those agents for treatment of Lyme disease. Erythromycin inhibits bacterial growth, possibly by blocking dissociation of peptidyl t-RNA from ribosomes, causing RNA-dependent protein synthesis to arrest.In children, age, weight, and severity of infection determine the proper dosage. When twice-daily dosing is desired, half the total daily dose may be taken every 12 hours. For more severe infections, double the dose.
Azithromycin (Zithromax, Zmax)
Azithromycin is a second-line drug. Like erythromycin, this agent has excellent in vitro sensitivities, but mixed data exist regarding its clinical efficacy in early Lyme disease. Because of its once-daily dosing, azithromycin can be considered in pregnant patients who are allergic to beta-lactams and in patients in whom compliance is a major issue.Clarithromycin (Biaxin, Biaxin XL)
Clarithromycin is a macrolide antibiotic that inhibits protein synthesis by binding to the 50S ribosomal subunit. This drug is not first-line therapy but is an alternative agent for patients intolerant of doxycycline, amoxicillin, and cephalosporins.