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
Dermatologic: skin rashes, exanthema, urticaria
Ocular: blurred vision
Oral granules: 10g
Oral tablet: 400mg
Susceptible infections: 400mg every 12 hours for 7-14 days
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
Paidocin/Promedica (Italy), and Rokital/Formenti (Italy)