<unk>  is used primarily to treat anaerobic infections caused by susceptible anaerobic bacteria, including dental infections, and infections of the respiratory tract, skin, and soft tissue, and peritonitis. In people with hypersensitivity to penicillins,<unk>  may be used to treat infections caused by susceptible aerobic bacteria, as well. It is also used to treat bone and joint infections, particularly those caused by Staphylococcus aureus. Topical application of<unk>  phosphate can be used to treat mild to moderate acne. Acne<unk>  phosphate topical solution For the treatment of acne, in the long term, the combined use of topical<unk>  and benzoyl peroxide was similar to salicylic acid plus benzoyl peroxide. Topical<unk>  plus topical benzoyl peroxide is more effective than topical<unk>  alone. Susceptible bacteria It is most effective against infections involving the following types of organisms: * Aerobic Gram-positive cocci, including some members of the Staphylococcus and Streptococcus (e.g. pneumococcus) genera, but not enterococci. * Anaerobic, Gram-negative rod-shaped bacteria, including some Bacteroides, Fusobacterium, and Prevotella, although resistance is increasing in Bacteroides fragilis. Most aerobic Gram-negative bacteria (such as Pseudomonas, Legionella, Haemophilus influenzae and Moraxella) are resistant to<unk> , as are the facultative anaerobic Enterobacteriaceae. A notable exception is Capnocytophaga canimorsus, for which<unk>  is a first-line drug of choice. The following represents MIC susceptibility data for a few medically significant pathogens. *Staphylococcus aureus: 0.016 μg/ml - >256 μg/ml *Streptococcus pneumoniae: 0.002 μg/ml - >256 μg/ml *Streptococcus pyogenes: 64 μg/ml D-test D-test When testing a gram-positive culture for sensitivity to<unk> , it is common to perform a "D-test" to determine if there is a macrolide-resistant subpopulation of bacteria present. This test is necessary because some bacteria express a phenotype known as MLSB, in which susceptibility tests will indicate the bacteria are susceptible to<unk> , but in vitro the pathogen displays inducible resistance. To perform a D-test, an agar plate is inoculated with the bacteria in question and two drug-impregnated disks (one with erythromycin, one with<unk>  are placed 15–20 mm apart on the plate. If the area of inhibition around the<unk>  disk is "D" shaped, the test result is positive and<unk>  should not be used due to the possibility of resistant pathogens and therapy failure. If the area of inhibition around the<unk>  disk is circular, the test result is negative and<unk>  can be used. Malaria Given with chloroquine or quinine,<unk>  is effective and well tolerated in treating Plasmodium falciparum malaria; the latter combination is particularly useful for children, and is the treatment of choice for pregnant women who become infected in areas where resistance to chloroquine is common.<unk>  should not be used as an antimalarial by itself, although it appears to be very effective as such, because of its slow action. Patient-derived isolates of Plasmodium falciparum from the Peruvian Amazon have been reported to be resistant to<unk>  as evidenced by in vitro drug susceptibility testing. Other<unk>  may be useful in skin and soft tissue infections caused by methicillin-resistant Staphylococcus aureus (MRSA). Many strains of MRSA are still susceptible to<unk> ; however, in the United States spreading from the West Coast eastwards, MRSA is becoming increasingly resistant. While it has been used in intraabdominal infections, such use is generally not recommended due to resistance.<unk>  is used in cases of suspected toxic shock syndrome, often in combination with a bactericidal agent such as vancomycin. The rationale for this approach is a presumed synergy between vancomycin, which causes the death of the bacteria by breakdown of the cell wall, and<unk> , which is a powerful inhibitor of toxin synthesis. Both in vitro and in vivo studies have shown<unk>  reduces the production of exotoxins by staphylococci; it may also induce changes in the surface structure of bacteria that make them more sensitive to immune system attack (opsonization and phagocytosis).<unk>  has been proven to decrease the risk of premature births in women diagnosed with bacterial vaginosis during early pregnancy to about a third of the risk of untreated women. The combination of<unk>  and quinine is the standard treatment for severe babesiosis.<unk>  may also be used to treat toxoplasmosis, and, in combination with primaquine, is effective in treating mild to moderate Pneumocystis jirovecii pneumonia.<unk> , either applied to skin or taken by mouth, may also be used in hidradenitis suppurativa.
Clindamycin
Meropenem
Resistin
Rifamycin
Aztreonam
Cefepime
Levofloxacin
Spiramycin