Mechanism of action<unk>  displays bacteriostatic activity or inhibits growth of bacteria, especially at higher concentrations. By binding to the 50s subunit of the bacterial rRNA complex, protein synthesis and subsequent structure and function processes critical for life or replication are inhibited.<unk>  interferes with aminoacyl translocation, preventing the transfer of the tRNA bound at the A site of the rRNA complex to the P site of the rRNA complex. Without this translocation, the A site remains occupied, thus the addition of an incoming tRNA and its attached amino acid to the nascent polypeptide chain is inhibited. This interferes with the production of functionally useful proteins, which is the basis of this antimicrobial action.<unk>  increases gut motility by binding to Motillin receptor, thus it is a Motillin receptor agonist in addition to its antimicrobial properties. Pharmacokinetics<unk>  is easily inactivated by gastric acid; therefore, all orally administered formulations are given as either enteric-coated or more-stable salts or esters, such as<unk>  ethylsuccinate.<unk>  is very rapidly absorbed, and diffuses into most tissues and phagocytes. Due to the high concentration in phagocytes,<unk>  is actively transported to the site of infection, where, during active phagocytosis, large concentrations of<unk>  are released. Metabolism Most of<unk>  is metabolised by demethylation in the liver by the hepatic enzyme CYP3A4. Its main elimination route is in the bile with little renal excretion, 2%-15% unchanged drug.<unk> 's elimination half-life ranges between 1.5 and 2.0 hours and is between 5 and 6 hours in patients with end-stage renal disease.<unk>  levels peak in the serum 4 hours after dosing; ethylsuccinate peaks 0.5-2.5 hours after dosing, but can be delayed if digested with food.<unk>  crosses the placenta and enters breast milk. The American Association of Pediatrics determined<unk>  is safe to take while breastfeeding. Absorption in pregnant patients has been shown to be variable, frequently resulting in levels lower than in nonpregnant patients.
Erythromycin
Cethromycin
Methicillin
Ampicillin
Meropenem
Clarithromycin
Natamycin
Cefotaxime