Choosing a macrolide: drug interactions must be taken into account.
(1) Some macrolides carry a strong risk of potentially severe drug interactions.  (2) Erythromycin is the macrolide with the biggest risk of interactions.  (3) Spiramycin is the macrolide with the smallest risk of interactions.  Azithromycin and dirithromycin also seem to have a low risk of interactions, but they are far more recent and therefore less well known.  (4) In first-line use, unless there are specific indications, a macrolide with a low risk of interactions should be used.
D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D000075202:Contraindications; D004347:Drug Interactions; D004917:Erythromycin / Q000009:adverse effects / Q000031:analogs & derivatives; D006801:Humans; D011446:Prospective Studies; D012308:Risk Management; D015572:Spiramycin / Q000009:adverse effects
D000900:Anti-Bacterial Agents; D004917:Erythromycin; D015572:Spiramycin