Clarithromycin Pathway

Clarithromycin, a semisynthetic macrolide antibiotic derived from erythromycin, is active against a wide range of microorganisms. Clarithromycin inhibits protein synthesis in bacteria by reversibly binding to the 50S ribosomal subunits. This inhibits the translocation of aminoacyl transfer-RNA and prevents peptide chain elongation. Clarithromycin is effective against Mycobacterium avium complex (MAC) and is used for the treatment of Helicobacter pylori-associated peptic ulcer disease, community-acquired pneumonia, sinusitis, and chronic bronchitis. Clarithromycin is also used to treat respiratory tract, sexually transmitted, otitis media, and AIDS-related infections. Clarithromycin is first metabolized to 14-OH clarithromycin. Like other macrolides, it then binds to the 50S subunit of the 70S ribosome of the bacteria, blocking RNA-mediated bacterial protein synthesis. Clarithromycin also inhibits the hepatic microsomal CYP3A4 isoenzyme and P-glycoprotein, an energy-dependent drug efflux pump.

References

1. Biaxin/Biaxin BID/Biaxin XL . (2009). [Electronic version]. e-CPS. Retrieved July 17, 2009.
2. Song, K.S. (2004). Ribosomal protein synthesis inhibitors. In S. Offermanns, & W. Rosenthal (Eds.). Encyclopedic reference of molecular pharmacology (pp. 827-833). Berlin, Germany: Springer.