The mechanism of action of macrolides has been a matter of controversy for some time. Spiramycin, a 16-membered macrolide, inhibits translocation by binding to bacterial 50S ribosomal subunits with an apparent 1 : 1 stoichiometry. This antibiotic is a potent inhibitor of the binding to the ribosome of both donor and acceptor substrates. The primary mechanism of action is done by stimulation of dissociation of peptidyl-tRNA from ribosomes during translocation.
Rovamycine has been reported to inhibit the absorption of carbidopa and decrease levodopa plasma levels. When necessary, patients should be closely monitored and the levodopa dosage levels adjusted.
Spiramycin is contraindicated in patients with known hypersensitivity to the drug. The levels of spiramycin attained in the cerebrospinal fluid are much lower than those in the blood and are too low to be clinically useful. Therefore Spiramycin must not be used in patients with meningitis.
Side effects of include: nausea, vomiting, diarrhea, inflamed bowels, pruritus (itchy skin), tingling or numbness in the skin.
Safety of this product for use during pregnancy has not been established.
Administer antibiotics, including Spiramycin cautiously to any patient who has demonstrated some form of allergy, particularly to drugs. The possibility of superinfection caused by overgrowth of nonsusceptible organisms should be kept in mind during prolonged or repeated therapy. If superinfection occurs, discontinue the drug and take appropriate measures.
