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1. Adverse events in people taking macrolide antibiotics versus placebo for any indication. (PubMed)

Adverse events in people taking macrolide antibiotics versus placebo for any indication. Macrolide antibiotics (macrolides) are among the most commonly prescribed antibiotics worldwide and are used for a wide range of infections. However, macrolides also expose people to the risk of adverse events. The current understanding of adverse events is mostly derived from observational studies, which are subject to bias because it is hard to distinguish events caused by antibiotics from events caused (...) by the diseases being treated. Because adverse events are treatment-specific, rather than disease-specific, it is possible to increase the number of adverse events available for analysis by combining randomised controlled trials (RCTs) of the same treatment across different diseases.To quantify the incidences of reported adverse events in people taking macrolide antibiotics compared to placebo for any indication.We searched the Cochrane Central Register of Controlled Trials (CENTRAL), which includes

2019 Cochrane

2. Macrolide antibiotics for bronchiectasis. (PubMed)

Macrolide antibiotics for bronchiectasis. Bronchiectasis is a chronic respiratory disease characterised by abnormal and irreversible dilatation and distortion of the smaller airways. Bacterial colonisation of the damaged airways leads to chronic cough and sputum production, often with breathlessness and further structural damage to the airways. Long-term macrolide antibiotic therapy may suppress bacterial infection and reduce inflammation, leading to fewer exacerbations, fewer symptoms (...) , improved lung function, and improved quality of life. Further evidence is required on the efficacy of macrolides in terms of specific bacterial eradication and the extent of antibiotic resistance.To determine the impact of macrolide antibiotics in the treatment of adults and children with bronchiectasis.We identified trials from the Cochrane Airways Trials Register, which contains studies identified through multiple electronic searches and handsearches of other sources. We also searched trial

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2018 Cochrane

3. Macrolides for treatment of Haemophilus ducreyi infection in sexually active adults. (PubMed)

Macrolides for treatment of Haemophilus ducreyi infection in sexually active adults. Chancroid is a genital ulcerative disease caused by Haemophilus ducreyi. This microorganism is endemic in Africa, where it can cause up to 10% of genital ulcers. Macrolides may be an effective alternative to treat chancroid and, based on their oral administration and duration of therapy, could be considered as first line therapy.To assess the effectiveness and safety of macrolides for treatment of H ducreyi (...) infection in sexually active adults.We searched the Cochrane STI Group Specialized Register, CENTRAL, MEDLINE, Embase, LILACS, WHO ICTRP, ClinicalTrials.gov and Web of Science to 30 October 2017. We also handsearched conference proceedings and reference lists of retrieved studies.Randomized controlled trials (RCTs) comparing macrolides in different regimens or with other therapeutic alternatives for chancroid.Two review authors independently assessed trials for inclusion, extracted data and assessed

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2017 Cochrane

4. Therapeutic efficacy of azithromycin, clarithromycin, minocycline and tosufloxacin against macrolide-resistant and macrolide-sensitive Mycoplasma pneumoniae pneumonia in pediatric patients. (PubMed)

Therapeutic efficacy of azithromycin, clarithromycin, minocycline and tosufloxacin against macrolide-resistant and macrolide-sensitive Mycoplasma pneumoniae pneumonia in pediatric patients. To clarify therapeutic effects of azithromycin, clarithromycin, minocycline and tosufloxacin against macrolide-resistant Mycoplasma pneumoniae (MRMP) pneumonia and against macrolide-sensitive Mycoplasma pneumoniae (MSMP) pneumonia in pediatric patients.A prospective, multicenter observational study (...) with MRMP compared to the duration of fever in patients treated with macrolides.

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2017 PLoS ONE

5. Prevalence of macrolide resistance in Treponema pallidum is associated with macrolide consumption. (PubMed)

Prevalence of macrolide resistance in Treponema pallidum is associated with macrolide consumption. We hypothesized that the large global variations in the prevalence of macrolide resistance in Treponema pallidum are related to differences in population-level macrolide consumption. The hypothesis was tested by, at a country-level, regressing the peak prevalence of macrolide resistance against the national macrolide consumption in the year prior to this, controlling for the year of the resistance (...) prevalence estimate. A strong association was found between the per capita consumption of macrolides and macrolide resistance (coefficient 0.7, 95 % confidence interval 0.2-0.12, P=0.009).

2018 Journal of Medical Microbiology

6. Therapeutic Efficacy and Safety of Prolonged Macrolide, Corticosteroid, Doxycycline, and Levofloxacin against Macrolide-Unresponsive Mycoplasma pneumoniae Pneumonia in Children (PubMed)

Therapeutic Efficacy and Safety of Prolonged Macrolide, Corticosteroid, Doxycycline, and Levofloxacin against Macrolide-Unresponsive Mycoplasma pneumoniae Pneumonia in Children We aimed to compare the therapeutic efficacy of prolonged macrolide (PMC), corticosteroids (CST), doxycycline (DXC), and levofloxacin (LFX) against macrolide-unresponsive Mycoplasma pneumoniae (MP) pneumonia in children and to evaluate the safety of the secondary treatment agents.We retrospectively analyzed the data (...) of patients with MP pneumonia hospitalized between January 2015 and April 2017. Macrolide-unresponsiveness was clinically defined with a persistent fever of ≥ 38.0°C at ≥ 72 hours after macrolide treatment. The cases were divided into four groups: PMC, CST, DXC, and LFX. We compared the time to defervescence (TTD) after secondary treatment and the TTD after initial macrolide treatment in each group with adjustment using propensity score-matching analysis.Among 1,165 cases of MP pneumonia, 190 (16.3%) were

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2018 Journal of Korean medical science

7. Evaluation of the Lightmix<sup>®</sup>Mycoplasma macrolide assay for the detection of macrolide resistant Mycoplasma pneumoniae in pneumonia patients. (PubMed)

Evaluation of the Lightmix®Mycoplasma macrolide assay for the detection of macrolide resistant Mycoplasma pneumoniae in pneumonia patients. Rapid detection of macrolide resistance-associated mutations in Mycoplasma pneumoniae is crucial for effective antimicrobial treatment. We evaluated the Lightmix Mycoplasma macrolide assay for the detection of point mutations at nucleotide positions 2063 and 2064 in the 23S ribosomal RNA (rRNA) gene of M. pneumoniae that confer macrolide (...) ) and a specificity of 100% (95% confidence interval, 97.5-100) as the detected M. pneumoniae genotype (148 wild type and 15 non-wild type) was confirmed by 23S rRNA sequencing in all samples.The Lightmix assay is an easy-to-use and accurate molecular test that allows rapid determination of macrolide resistance in M. pneumoniae.Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

2018 Clinical Microbiology and Infection

8. Mechanism of macrolide-induced inhibition of pneumolysin release involves impairment of autolysin release in macrolide-resistant <i>Streptococcus pneumoniae</i>. (PubMed)

Mechanism of macrolide-induced inhibition of pneumolysin release involves impairment of autolysin release in macrolide-resistant Streptococcus pneumoniae. Streptococcus pneumoniae is a leading cause of community-acquired pneumonia. Over the past 2 decades, macrolide resistance among S. pneumoniae organisms has been increasing steadily and has escalated at an alarming rate worldwide. However, the use of macrolides in the treatment of community-acquired pneumonia has been reported (...) to be effective regardless of the antibiotic susceptibility of the causative pneumococci. Although previous studies suggested that sub-MICs of macrolides inhibit the production of the pneumococcal pore-forming toxin pneumolysin by macrolide-resistant S. pneumoniae (MRSP), the underlying mechanisms of the inhibitory effect have not been fully elucidated. Here, we show that the release of pneumococcal autolysin, which promotes cell lysis and the release of pneumolysin, was inhibited by treatment

2018 Antimicrobial Agents and Chemotherapy

9. Development of macrolide resistance-associated mutations after macrolide treatment in children infected with Mycoplasma pneumoniae. (PubMed)

Development of macrolide resistance-associated mutations after macrolide treatment in children infected with Mycoplasma pneumoniae. To determine the timing of the emergence of macrolide-resistant mutations after macrolide treatment in individuals with Mycoplasma pneumoniae infections.Between October 2011 and December 2013, serial pharyngeal swab specimens were collected before and after macrolide treatment from 21 otherwise healthy children infected with M. pneumoniae without macrolide (...) -resistant mutations. The copy numbers of a M. pneumoniae gene and the proportion of clones showing macrolide-resistance mutations were determined for each specimen.After macrolide treatment (10-15 mg kg-1 day-1 clarithromycin for 5-10 days or 10 mg kg-1 day-1 azithromycin for 3 days), fever resolved in 19 (90 %) of 21 children within 1 to 2 days, and the M. pneumoniae gene copy number decreased in all but one specimen in the second set of specimens relative to the number in the corresponding initial

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2017 Journal of Medical Microbiology

10. A Population-Based Assessment of the Impact of 7- and 13-Valent Pneumococcal Conjugate Vaccines on Macrolide-Resistant Invasive Pneumococcal Disease: Emergence and Decline of Streptococcus pneumoniae Serotype 19A (CC320) With Dual Macrolide Resistance Mec (PubMed)

A Population-Based Assessment of the Impact of 7- and 13-Valent Pneumococcal Conjugate Vaccines on Macrolide-Resistant Invasive Pneumococcal Disease: Emergence and Decline of Streptococcus pneumoniae Serotype 19A (CC320) With Dual Macrolide Resistance Mec Macrolide efflux encoded by mef(E)/mel and ribosomal methylation encoded by erm(B) confer most macrolide resistance in Streptococcus pneumoniae. Introduction of the heptavalent pneumococcal conjugate vaccine (PCV7) in 2000 reduced macrolide (...) -resistant invasive pneumococcal disease (MR-IPD) due to PCV7 serotypes (6B, 9V, 14, 19F, and 23F).In this study, the impact of PCV7 and PCV13 on MR-IPD was prospectively assessed. A 20-year study of IPD performed in metropolitan Atlanta, Georgia, using active, population-based surveillance formed the basis for this study. Genetic determinants of macrolide resistance were evaluated using established techniques.During the decade of PCV7 use (2000-2009), MR-IPD decreased rapidly until 2002 and subsequently

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2017 Clinical Infectious Diseases

11. Associations between use of macrolide antibiotics during pregnancy and adverse child outcomes: A systematic review and meta-analysis. (PubMed)

Associations between use of macrolide antibiotics during pregnancy and adverse child outcomes: A systematic review and meta-analysis. Evidence on adverse effects of maternal macrolide use during pregnancy is inconsistent. We conducted a systematic review and meta-analysis to investigate the association between macrolide use during pregnancy and adverse fetal and child outcomes.We included observational studies and randomised controlled trials (RCTs) that recorded macrolide use during pregnancy (...) and child outcomes. We prioritized comparisons of macrolides with alternative antibiotics (mainly penicillins or cephalosporins) for comparability of indication and effect. Random effects meta-analysis was used to derive pooled odds ratios (OR) for each outcome. Subgroup analyses were performed according to specific types (generic forms) of macrolide. Of 11,186 citations identified, 19 (10 observational, 9 RCTs) studies were included (21 articles including 228,556 participants). Macrolide prescribing

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2019 PLoS ONE

12. Genetic characterization of Mycoplasma pneumoniae isolated in Osaka between 2011 and 2017: Decreased detection rate of macrolide-resistance and increase of p1 gene type 2 lineage strains. (PubMed)

Genetic characterization of Mycoplasma pneumoniae isolated in Osaka between 2011 and 2017: Decreased detection rate of macrolide-resistance and increase of p1 gene type 2 lineage strains. We characterized 419 Mycoplasma pneumoniae isolates collected between 2011 and 2017 in Osaka prefecture of Japan. This analysis revealed high prevalence of macrolide-resistant M. pneumoniae (MRMP) in Osaka during 2011 and 2014 with annual detection rates of MRMP strains between 71.4% and 81.8%. However (...) , in 2015 and after, the detection rate of MRMP decreased significantly and did not exceed 50%. Genotyping of the p1 gene of these isolates showed that most of MRMP strains harbored type 1 p1 gene. In contrast, strains expressing p1 gene type 2 or its variant were largely macrolide-susceptible M. pneumoniae (MSMP) strains. There was a strong correlation between p1 gene genotype and the presence of mutations conferring macrolide resistance in M. pneumoniae isolated in Osaka. These results indicate

2019 PLoS ONE

13. Macrolides for chronic asthma. (PubMed)

Macrolides for chronic asthma. Asthma is a chronic disease in which inflammation of the airways causes symptomatic coughing, wheezing, and difficult breathing. The inflammation may have different underlying causes, including a reaction to infection in the lungs. Macrolides are antibiotics with antimicrobial and antiinflammatory activities that have been used long-term to control asthma symptoms.To assess the effects of macrolides for managing chronic asthma.We searched the Cochrane Airways (...) Group Specialised Register up to April 2015. We also manually searched bibliographies of previously published reviews and conference proceedings and contacted study authors. We included records published in any language in the search.Randomised controlled clinical trials involving both children and adults with chronic asthma treated with macrolides versus placebo for more than four weeks .Two reviewers independently examined all records identified in the searches then reviewed the full text of all

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2015 Cochrane

14. Macrolides for diffuse panbronchiolitis. (PubMed)

Macrolides for diffuse panbronchiolitis. Diffuse panbronchiolitis (DPB) is a chronic airways disease predominantly affecting East Asians. Macrolides, a class of antibiotics, have been used as the main treatment for DPB, based on evidence from retrospective and non-randomised studies.To assess the efficacy and safety of macrolides for DPB.We searched CENTRAL (2014, Issue 6), MEDLINE (1966 to July week 1, 2014), EMBASE (1974 to July 2014), Chinese Biomedical Literature Database (CBM) (1978 (...) to July 2014), China National Knowledge Infrastructure (CNKI) (1974 to July 2014), KoreaMed (1997 to July 2014) and Database of Japana Centra Revuo Medicina (1983 to July 2014).Randomised controlled trials (RCTs) or quasi-RCTs assessing the effect of macrolides for DPB.Two review authors independently assessed study quality and subsequent risk of bias according to The Cochrane Collaboration's tool for assessing risk of bias. The primary outcomes were five-year survival rate, lung function and clinical

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2015 Cochrane

15. A systematic review and meta-analysis of surgical site infection post- caesarean section following prophylactic adjunctive macrolides.

A systematic review and meta-analysis of surgical site infection post- caesarean section following prophylactic adjunctive macrolides. Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration

2019 PROSPERO

16. Comparing the clinical outcomes of quinolones versus macrolides in the treatment of legionella pneumonia: a systematic review and meta-analysis

Comparing the clinical outcomes of quinolones versus macrolides in the treatment of legionella pneumonia: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content

2019 PROSPERO

17. In Vitro Activity of Lefamulin and Other Antimicrobial Agents Against Macrolide-Susceptible and Macrolide-Resistant Mycoplasma pneumoniae from the United States, Europe, and China. (PubMed)

In Vitro Activity of Lefamulin and Other Antimicrobial Agents Against Macrolide-Susceptible and Macrolide-Resistant Mycoplasma pneumoniae from the United States, Europe, and China. Lefamulin, an investigational pleuromutilin, was tested against a collection of 18 macrolide-susceptible and 42 macrolide-resistant Mycoplasma pneumoniae strains, and the results were compared with those of azithromycin, erythromycin, tetracycline, doxycycline, and moxifloxacin testing. Lefamulin was highly active (...) against all strains tested, with all MICs at ≤0.008 μg/ml. The lefamulin MIC90 (0.002 μg/ml) for macrolide-resistant strains was the lowest among all drugs tested. Minimum bactericidal concentrations were within 2 dilutions of the MIC values, indicating a bactericidal effect.Copyright © 2017 American Society for Microbiology.

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2016 Antimicrobial Agents and Chemotherapy

18. Macrolide and fluoroquinolone resistance-associated mutations in Mycoplasma genitalium in Johannesburg, South Africa, 2007-2014. (PubMed)

Macrolide and fluoroquinolone resistance-associated mutations in Mycoplasma genitalium in Johannesburg, South Africa, 2007-2014. Antimicrobial resistance in Mycoplasma genitalium is rising globally with resultant clinical treatment failure. We investigated the prevalence of mutations in the macrolide and fluoroquinolone resistance-determining regions of M. genitalium in Johannesburg, South Africa, and ascertained their association with HIV serostatus.Stored M. genitalium positive specimens (...) , collected from STI and HIV patients enrolled in the Gauteng STI National Microbiological Surveillance programme (2007-2014) and a large HIV outpatient clinic-based study (2007) in Johannesburg, were tested for antimicrobial resistance.We determined the prevalence of 23S rRNA gene mutations conferring macrolide resistance and mutations in the quinolone resistance-determining regions (QRDR) of the gyrA and parC genes in 266 M. genitalium positive DNA extracts. No macrolide resistance-associated mutations

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2019 BMC Infectious Diseases

19. Rapid molecular detection of macrolide resistance. (PubMed)

Rapid molecular detection of macrolide resistance. Emerging antimicrobial resistance is a significant threat to human health. However, methods for rapidly diagnosing antimicrobial resistance generally require multi-day culture-based assays. Macrolide efflux gene A, mef(A), provides resistance against erythromycin and azithromycin and is known to be laterally transferred among a wide range of bacterial species.We use Recombinase Polymerase Assay (RPA) to detect the antimicrobial resistance gene

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2019 BMC Infectious Diseases

20. Factors of success of low-dose macrolides in chronic sinusitis: Systematic review and meta-analysis. (PubMed)

Factors of success of low-dose macrolides in chronic sinusitis: Systematic review and meta-analysis. To assess the prognostic factors that predict favorable outcomes of low-dose macrolides (LDMs) in treating chronic rhinosinusitis (CRS).Randomized controlled trials studying the effects of LDMs in treating CRS were included. Data were pooled for meta-analysis. Primary outcome was Sino-Nasal Outcome Test (SNOT). Six prognostic factors: CRS subtypes, serum immunoglobulin (Ig)E level, membered (...) lactone ring of macrolides, concurrent endoscopic sinus surgery (ESS), and dosage and duration of the LDMs were assessed by subgroup analyses.Ten studies (608 patients) met the inclusion criteria. LDMs and placebo were not different in SNOT improvement (standardized mean difference [SMD] = -0.23, 95% confidence interval [CI]: -0.69 to 0.24). Subgroup analyses showed that the effects favored LDMs in the patients with CRS without polyps (SMD = -0.64, 95% CI: -1.01 to -0.27) compared to CRS with polyps

2019 Laryngoscope

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