A principal maneira que teñen as bacterias de adquirir resistencia aos macrólidos é por medio de metilación post-transcricional do [[ARN ribosómico]] de 23 S bacteriano. Esta resistencia adquirida pode estar mediada tanto por [[plásmido]]s coma polo cromosoma, por medio de mutacións, e orixina unha resistencia cruzada a macrólidos, [[lincosamida]]a, e [[estreptogramina]]s (un fenotipo MLS-resistente).
The primary means of bacterial resistance to macrolides occurs by post-transcriptional methylation of the [[23S ribosomal RNA|23S]] bacterial ribosomal RNA. This acquired resistance can be either [[plasmid]]-mediated or chromosomal, i.e., through mutation, and results in cross-resistance to macrolides, [[lincosamides]], and [[streptogramins]] (an MLS-resistant phenotype).
Outros tipos de resistencia adquirida que se dan raramente son a produción de encimas que inactivan o fármaco ([[esterase]]s ou [[quinase]]s), ou tamén a produción de fluxos de proteínas activos dependentes do ATP, que transportan a substancia fóra da célula.
Two other types of acquired resistance rarely seen include the production of drug-inactivating enzymes (esterases or kinases), as well as the production of active ATP-dependent efflux proteins that transport the drug outside of the cell.
AzithromycinA hasazitromicina beenfoi usedutilizada topara treattratar strepa throatinfección ([[Groupde Agorxa streptococcal]]causada (GAS) infection caused bypor ''[[Streptococcus pyogenes]]'' (estreptococos do grupo A ) inen penicillin-sensitivepacientes patientsalérxicos á [[penicilina]], however macrolide-resistant strains of GAS are not uncommon. [[Cephalosporin]]Outra isposible anotheropción optionpara forestres thesepacientes patientsé a [[cefalosporina]].
