Mechanisms of Resistance to Macrolides and Lincosamides: Nature of the Resistance Elements and Their Clinical Implications
Abstract
Resistance to macrolides and lincosamides is increasingly reported in clinical isolates of gram-positive bacteria. The multiplicity of mechanisms of resistance, which include ribosomal modification, efflux of the antibiotic, and drug inactivation, results in a variety of phenotypes of resistance. There is controversy concerning the clinical relevance of in vitro macrolide resistance. Recent data, however, have shown that eradication of bacteria correlates with clinical outcome of acute otitis media in children and that macrolide therapy results in delayed eradication of macrolide-resistant pneumococci. These results support the need for in vitro detection of macrolide resistance and correct interpretation of susceptibility tests to guide therapy.
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Because macrolides, lincosamides and streptogramin B antibiotics have overlapping binding sites in the 23S rRNA, expression of erm genes confers cross-resistance to all members of the MLSB group.
“Importantly, since macrolides, lincosamides, and streptogramin B antibiotics have overlapping binding sites in the 23S rRNA, expression of the erm genes confers cross-resistance to all members of the MLSB group (62, 63).”
From Mechanisms of Antibiotic Resistance (2016) · cites this paper as [62]
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- Authors
- Leclercq, R.
- Affiliations
- Centre Hospitalier Universitaire de Caen Normandie (FR)
- Corresponding author
- Leclercq, Roland
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2002-02
- Volume
- 34
- Issue
- 4
- Pages
- 482-492
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2097618796
- Cited by
- 1,102
- References
- 74
- Citations by year
- 2026: 44 · 2025: 69 · 2024: 51 · 2023: 65 · 2022: 58 · 2021: 68 · 2020: 76 · 2019: 51 · 2018: 35 · 2017: 60 · 2016: 70 · 2015: 52 · 2014: 41 · 2013: 36 · 2012: 31
- FWCI
- 2.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
- Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Keywords
- macrolide resistance, lincosamide resistance, Gram-positive bacteria, efflux pumps, antibiotic inactivation, in vitro susceptibility testing, acute otitis media, Streptococcus pneumoniae, antibiotic eradication, clinical outcomes
- MeSH terms
- Anti-Bacterial Agents, Biological Transport, Biotransformation, DNA, Ribosomal, Humans, Mutation, Genetic Variation, Outcome Assessment, Health Care, Macrolides, DNA Methylation, Drug Resistance, Bacterial, Lincosamides
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