[Role of macrolides in the treatment of respiratory tract infections in children].
Macrolides are antibiotics with high intracellular concentrations. They have a bacteriostatic activity but are also bactericides for concentrations five times greater than the minimal inhibitory concentration, concentrations in which they reach in the respiratory tract. They are usually active on Streptococcus, Neisseria, Moraxella catarrhalis, Listeria monocytogenes, Bordetella pertussis, Pasteurella multocida, Chlamydia, Mycoplasma pneumoniae, Legionella pneumophila and Helicobacter pylori. They have few secondary effects, some in relation with drug interactions. Their main indications are bronchopulmonary infections due to Mycoplasma pneumoniae, Chlamydia pneumoniae, Chlamydia trachomatis and Legionella pneumophila. They are also useful in whooping cough allowing the eradication of Bordetella pertussis in the rhinopharynx, thus limiting the dissemination of the infection in children. In amygdalitis and pharyngitis, macrolides are a good substitute in the case of allergy to penicillin. New generation of macrolides (roxithromycine, clarithromycine, dirithromycine, azithromycine) might open other interesting therapeutic perspectives.
Unité d'urgence et de réanimation pédiatrique, hôpital Edouard-Herriot, Lyon, France.
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D000900:Anti-Bacterial Agents / Q000145:classification / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002648:Child; D004361:Drug Tolerance; D006801:Humans; D018942:Macrolides; D012141:Respiratory Tract Infections / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D018942:Macrolides
Place des macrolides dans le traitement des infections respiratoires de l'enfant.