Prevents bacterial protein synthesis by binding to the 30S ribosomal subunit, blocking the binding of aminoacyl-tRNA to the acceptor site on the mRNA-ribosome complex

GI upset, hepatotoxicity, photosensitivity, collects in Ca⁺² deposits bone and teeth (in fetus and young children), renal toxicity, vestibular reactions

Mycoplasma, chlamydiae, reckettsiae, some spirochetes; malaria; H pylori; acne

Prevents bacterial protein synthesis by binding to the 50S ribosomal subunit

GI upset, hepatotoxicity, QT_c prolongation; inhibits P450

Ototoxicity

Community-acquired pneumonia; pertussis; corynebacterial, and chlamydial infections

Prevents bacterial protein synthesis by binding to the 50S ribosomal subunit

Same as erythromycin; Longer half-life

“ototoxicity

Added activity versus Mycobacterium avium complex, toxoplasma, and M leprae

Binds to 50S ribosomal subunit

Very long half-life (68h);does not inhibit cytochrome P450

“ototoxicity

5 day course of therapy of community-acquired pneumonia

Binds to 50S ribosomal subunit

Unaffected by efflux-mediated resistance = broader activity

Rare cases of fulminant hepatic failure; ototoxicity

Active versus many erythromycin-resistant strains of pneumococci

Binds to 50S ribosomal subunit

GI upset, difficile colitis

Pseudomembranous colitis

Skin and soft tissue infections,  MRSA, anaerobic infections

Binds to 50S ribosomal subunit

Severe infusion-related myalgias and arthralgias

Staphylococci or vancomycin-resistant strains of faecium

Binds to 50S ribosomal subunit

Dose-related anemia, idiosyncratic aplastic anemia, hemolytic anemia, gray baby syndrome

Use is rare in the developed world because of serious toxicities

Prevents bacterial protein synthesis by binding to the 23S ribosomal RNA of 50S subunit

Duration-dependent bone marrow suppression, neuropathy, and optic neuritis; serotonin-syndrome; pseudomembranous colitis

Methicillin-resistant staphylococci and vancomycin-resistant enterococci

Bind to 30S-subunit ribosomal proteins.  Inhibit protein synthesis in at least 3 ways:

Nephrotoxicity (reversible), ototoxicity (irreversible), neuromuscular blockade

 Renal damage/renal failure

Synergistic effects against gram-positive bacteria when combined with β lactams or vancomycin (break down cell wall so drugs can diffuse into cell)

Widespread resistance limits use

Mainly 2^nd line drug for TB

Bind to 30S-subunit ribosomal proteins.Inhibit protein synthesis in at least 3 ways:

Nephrotoxicity (reversible), ototoxicity (irreversible), neuromuscular blockade

Renal damage/renal failure

Synergistic effects against gram-positive bacteria when combined with β lactams or vancomycin (break down cell wall so drugs can diffuse into cell)

Sepsis caused by aerobic gram-negative bacteria;

Bind to 30S-subunit ribosomal proteins.Inhibit protein synthesis in at least 3 ways:

Nephrotoxicity (reversible), ototoxicity (irreversible), neuromuscular blockade

Renal damage/renal failure

Synergistic effects against gram-positive bacteria when combined with β lactams or vancomycin (break down cell wall so drugs can diffuse into cell)

Less nephrotoxicity

More active against pseudomonas

Bind to 30S-subunit ribosomal proteins.Inhibit protein synthesis in at least 3 ways:

Nephrotoxicity (reversible), ototoxicity (irreversible), neuromuscular blockade

Renal damage/renal failure

Synergistic effects against gram-positive bacteria when combined with β lactams or vancomycin (break down cell wall so drugs can diffuse into cell)

Resistant to many enzymes that inactivate gentamicin and tobramycin

Multi-drug resistant TB

Structurally related to aminoglycosides

Sole use is for treatment of antibiotic-resistant gonococcal infections or gonococcal infections in penicillin allergic patients