Macrolides and lincosamides

Key points


General

Pharmacodynamics

Beneficial actions and effects

Resistance (by bacteria)

Adverse effects

Pharmacokinetics

Available agents


Macrolides


Erythromycin

  • Oldest of macrolides
  • More commonly used in small animals than others
    • Oral absorption of erythromycin is variable but reasonably good. Many dose forms available on human market (most attempt to reduce GI side effects). (> 50%) Absorption probably varies by dose form.
    • Multiple human dose forms lead to dosing confusion
    • Large volume of distribution but small compared to azithromycin, clarithromycin and new macrolides for food animal uses
erythromycin stearate tablets

Azithromycin

  • Large volume of distribution (compared to erythromycin)
  • Infrequent dosing
  • Azithromycin appears to be reasonably well absorbed (F=60% in cats, 90+% in dogs)
  • Probably useful in cats and foals
azithromycin tablets

Clarithromycin

  • Large volume of distribution (compared to erythromycin)
  • Infrequent dosing
  • Clarithromycin reasonably well absorbed in dogs and foals.
  • Probably useful in cats and foals
clarithromycin oral suspension

Tilmicosin

  • First of the "modern" macrolides for food animals
  • Injectable
  • Medicated feed
tilmicosin for injection tilmicosin type A medicated article

Tulathromycin

  • Larger volume of distribution than tilmicosin
  • Less resistance (than tilmicosin) reported (so far)
tulathromycin for injection

Gamithromycin

  • Larger volume of distribution than tilmicosin
  • Less resistance (than tilmicosin) reported (so far)
gamithromycin for injection

Tildipirosin

  • Larger volume of distribution than tilmicosin
  • Less resistance than other macrolides (reported so far)
tildipirosin for injection

Lincosamides


Lincomycin

lincomycin tablets lincomycin soluble powderlincomycin for injection

Clindamycin

  • larger volume of distribution than lincomycin
  • longer T1/2 than lincomycin
  • Noted especially for anaerobic activity
clindamycin topical gel clindamycin oral drops clindamycin capsules

Erythromycin
Macrolides
Lincosamides