[New macrolides].

Abstract

INTRODUCTION: Following their use for a few years, the place of new macrolides can be assessed. CURRENT KNOWLEDGE AND KEY POINTS: "New macrolides", ie, roxithromycin, clarithromycin, azithromycin and dirithromycin, are derivated from erythromycin and defined by different pharmacokinetic parameters: longer half time with better oral administration and shorter duration of treatment, better tissue concentrations with reduction of dosages and better tolerance, high cellular concentration with good activity. However, new macrolides and erythromycin do not show major differences in their antibacterial spectrum against usual pyogenic strains. Clinical use of new macrolides extends to opportunistic infections, such as atypical mycobacterial infections or toxoplasmosis, occurring in the course of HIV infection. New macrolides are also recommended for the treatment of Helicobacter pylori-related gastroduodenal ulcer. FUTURE PROSPECTS AND PROJECTS: New macrolides have opened new avenues in the development of anti-infectious strategies. Due to their good efficacy against Chlamydia pneumoniae which is suspected of inducing vascular diseases, the upcoming use of ketolids and the development of their non-antibiotic effects, the future of macrolides is favorable.