Macrolides is a class of antibacterial drugs that contain a large macrocyclic lactone ring substituted with certain unusual sugars. This class comprises drugs that inhibit protein synthesis in harmful and infectious gram-positive bacteria. These molecules bind to the 50S ribosomal unit, thereby restricting the ribosomes from carrying out the bacterial protein synthesis. Protein synthesis in bacteria is inhibited by macrolide drugs. Macrolide drugs are primarily bacteriostatic; however, they may be bactericidal at high concentrations or depending on the type of bacterial strain. These drugs were first extracted from Streptomyces erythraeus. The drug was named erythromycin back in the 1950s. Two other synthetic derivatives viz. clarithromycin and azithromycin were later developed by utilizing erythromycin in the 1970s and 1980s respectively.
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Macrolides have a broad spectrum of activity and are effective against several bacterial strains of Streptococcus, Clostridium, Corynebacterium, Haemophilus, Listeria, Legionella, Staphylococcus, Mycoplasma sp., and Neisseria meningitidis. Macrolide drugs are active against gram-positive bacteria, as they can easily penetrate the cell walls of gram-positive bacteria. Neither peptidoglycan (present in bacterial cell walls) nor the cytoplasmic membrane act as a barrier to these molecules when they enter the cell walls of gram-positive bacteria. However, macrolides are inactive in case of a gram-negative bacteria, as they are unable to penetrate the cell walls of gram-negative bacteria. This is because the outer membrane of these cells is hydrophilic with aqueous porins and on the other hand, macrolides are lyophilic in nature.
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Some of the major antibacterial drugs that belong to the macrolide drug class are erythromycin, clarithromycin, azithromycin, dirithromycin, roxithromycin, troleandomycin, fidaxomicin, and telithromycin. Macrolides accounted for 7.0% share of the global antibacterial drugs industry in 2014. The global macrolide drugs market is anticipated to expand at a moderate rate during the forecast period. Key growth drivers for the market include the increasing prevalence of infectious diseases, growing elderly population, increasing number of multidrug-resistant bacterial strains, and higher benefits over traditional antibiotics. Most developed economies such as the U.S., Japan, and countries of Western Europe have large elderly population that is more prone to various bacterial infections primarily caused by low immunity. Also, macrolides exhibit different characteristics such as good oral absorption, easy absorption in tissues, easier dosage of once or twice a day, and lower incidence of side-effects. These make macrolides more useful that other antibacterial drugs. Also, they can be utilized widely to treat mild-to-moderate bacterial infections. However, in some cases, liver injuries have been observed due to usage of macrolides. This factor along with patent expiries and influx of generic drugs may restrain the market for macrolide drugs during the forecast period.
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The global macrolide drugs market can be segmented based on type of drug, distribution channel, and region. Based on type of drug, the market has been divided into drugs such as erythromycin, clarithromycin, azithromycin, dirithromycin, roxithromycin, troleandomycin, fidaxomicin, and telithromycin. Based on distribution channel, the market has been classified into hospital pharmacies, clinics, hospitals, retail pharmacies, and online pharmacies.
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