Macroral
Macroral Uses, Dosage, Side Effects, Food Interaction and all others data.
Macroral is a naturally occurring 16-membered macrolide that fits under the category of acetoxy-substituted macrolide antibiotics. In this molecule, an acetoxy group is substituted on the position 9 of the 16-member ring and on position 4 of the terminal sugar. Until 2017, midecamycin was still under the list of approved antimicrobial active pharmaceutical ingredients by Health Canada.
Reports have indicated that midecamycin is active against both erythromycin-susceptible and efflux-mediated erythromycin-resistant strains. The diacetate form of this product reduces gastrointestinal side effects and improves its pharmacokinetic profile. Studies have proved that midecamycin is highly active against Gram-positive organisms. The activity of midecamycin in the form of acetate salt presents a better activity, which seems to be potentiated at pH 7-8, as well as a longer half-life.
| Trade Name | Macroral |
| Generic | Midecamycin |
| Midecamycin Other Names | Espinomycin A, Medecamycin A1, Medemycin A1, Midecamycin, Midecamycin A1, Momicine, Mydecamycin A1, Platenomycin B1, Rubimycin, Turimycin P3 |
| Type | |
| Formula | C41H67NO15 |
| Weight | Average: 813.979 Monoisotopic: 813.451070461 |
| Protein binding | Midecamycin does not bind to plasma proteins in a significant proportion and thus, the bound form can account for about 15% of the administered dose. The acetate form of midecamycin presents a larger protein binding. |
| Groups | Experimental |
| Therapeutic Class | |
| Manufacturer | |
| Available Country | Italy |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Macroral is a macrolide antibiotic used to treat a variety of infections caused by susceptible bacteria.
Macroral was used for the treatment of infections in the oral cavity, upper and lower respiratory tracts and skin and soft tissue infections. The alone use of midecamycin was mainly used in Europe or Japan.
Macroral is also used to associated treatment for these conditions: Abscess bacterial, Bacterial Pneumonia, Bronchitis bacterial, Laryngitis bacterial, Otitis Media (OM), Pharyngitis bacterial, Tonsillitis bacterial
How Macroral works
Macroral, as part of the macrolides, act by inhibiting bacterial protein synthesis. More specifically, midecamycin inhibits bacterial growth by targetting the 50S ribosomal subunit preventing peptide bond formation and translocation during protein synthesis. The presence of mutations in the 50S RNA can prevent midecamycin binding. Macroral is a broad spectrum antibiotic and thus, it can interact with different bacteria.
Volume of Distribution
The reported apparent volume of distribution of midecamycin is 7.7 L/kg.
Elimination Route
Macroral is rapidly and almost completely absorbed when orally administered. It is mainly absorbed in the alkaline intestinal environment. This rapid absorption is due to its liposoluble property which allows for good penetration in the tissues, especially bronchial secretion, prostatic tissue, middle ear exudates and bone tissue. The tissue/serum ratio concentration is greater than 1 which indicates that this product does not stay long in the plasma. After oral administration of 600 mg of midecamycin, the peak serum concentration is 0.8 mg/L and it is attained 1 hour after oral administration. This concentration dereased significantly after 4-6 hours.
Half Life
The half-life of midecamycin is longer than the first macrolide antibiotics. after intravenous administration, the half-life reported is of 54 minutes.
Clearance
Macroral presentas a low renal clearance value.
Elimination Route
The major route of elimination of midecamycin is is the liver, followed by a low significance of renal elimination. Urinary concentrations accounts for about 3.3% of the administered dose after 6 hours.
Innovators Monograph
You find simplified version here Macroral
