Macrolide
Gram-positive bacteria, Enterococcus faecalis, Enterococcus faecius, H. influenzae, Neisseria gonorrhoeae, Moraxella catarrhalis, Bacteroides fragilis
Macrolides are inhibitors of protein synthesis. They impair the elongation cycle of the peptidyl chain by specifically binding to the 50 S subunit of the ribosome. Specificity towards prokaryotes relies upon the absence of 50S ribosomes in eukaryotes.
Macrolides are considered time-dependent antibiotics.
Tmax (h): 0.5-1, T ½ (h): 2-3, AUC (mg *h/L): 2.05
Gastrointestinal: stomach discomfort, nausea, vomiting, epigastric pain
Hepatic: liver function abnormalities
Hematologic: eosinophilia
Dermatologic: skin rashes, exanthema, urticaria
Ocular: blurred vision
Oral granules: 10g
Oral tablet: 400mg
Susceptible infections: 400mg every 12 hours for 7-14 days
Disease state based dosing:
None necessary
Contraindications/Warnings/Precautions:
Contraindications: hypersensitivity to rokitamycin.
Precautions: biliary occlusion, liver disease, concurrent use of ergotamine or carbamazepine.
Ergot Derivatives: (major severity):
MOA: inhibition of cytochrome P450 3A4-mediated ergot derivative metabolism by a macrolide antibiotic
Management: The concurrent use of an ergot derivative and a macrolide antibiotic, such as rokitamycin, is contraindicated.
The manufacturer suggests that rokitamycin not be administered during pregnancy and lactation unless extreme circumstances require its use.
Therapeutic: Periodic WBC, chest X-ray if pneumonia, cultures, vital signs
Brand names/Manufacturer: Paidocin/Promedica (Italy), and Rokital/Formenti (Italy)