Current Macrolide Antibiotics and Their Mechanisms of Action

Macrolide antibiotics have a durable history of successful development, effectiveness, and safety since their discovery in 1952. Macrolides range from the prototypical erythromycin with a 14-membered lactone ring to members containing 15-(azithromycin) and 16-membered lactone rings to novel semisynthetic macrolide products such as nafithromycin, an engineered ketolide derived from the founding erythromycin structure. This chapter will introduce macrolides broadly, discuss the structure and mode of action of current macrolide antibiotics, detail the current clinical use of macrolides, and provide a view of future uses of macrolides, with a specific look at current challenges and new macrolides undergoing clinical trials.