Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 3 complete abstracts (706 words), 9 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
A group of often glycosylated macrocyclic compounds formed by chain extension of multiple propionates cyclized into a large (typically 12, 14, or 16)-membered lactone. Macrolides belong to the polyketides class of natural products, and many members exhibit antibiotic properties.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Macrolide.
Where it fits in the MeSH classification
- Broader topics
- Lactones; Polyketides
- Narrower topics
- Amphidinolides; Fidaxomicin; Lucensomycin; Maytansine; Mepartricin; Miocamycin; Natamycin; Nystatin; Oleandomycin; Oligomycins; Sirolimus; Tacrolimus; Tylosin; Amphotericin B
Related concepts
- Propionates
- Polyketides
- Antibiotic
Research landscape
PubMed indexes 130,920 records tagged with the MeSH heading “Macrolides” (counts retrieved 2026-10-31). 21,121 of them (16.1%) were published from 2020 onward, and the busiest period so far is through 1999 with 39,163 records.
Reviews account for 11,721 records (9.0%) and meta-analyses for 1,194. Randomized controlled trials number 7,816 (6.0%) as a share of all records on the topic.
Show the data
| Period | Records |
|---|---|
| through 1999 | 39,163 |
| 2000-2009 | 32,778 |
| 2010-2019 | 37,858 |
| 2020 onward | 21,121 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 11,721 | 9.0% |
| Meta-analyses | 1,194 | 0.9% |
| Randomized controlled trials | 7,816 | 6.0% |
Method: PubMed query "Macrolides"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.
Reading the evidence in drugs and chemicals
Studies of a chemical or drug can answer very different questions: what it is and how it behaves in cells and animals, how the body handles it, and whether it changes outcomes in people. Laboratory and animal findings often do not carry over to patients, and observational studies of exposures are confounded by who uses a substance and why. Nothing on this page is a recommendation to use, avoid, start or stop any substance or medicine; talk to a qualified clinician or pharmacist about your own situation. Check the dose, the species, the comparison group and whether a patient-relevant outcome was measured.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Mechanical loading induces the longitudinal growth of muscle fibers via a rapamycin-insensitive mechanism | 2026 | Research article Design not recorded in structured metadata | 7 | cc by PMID 41686888 · DOI · PMC12904167 |
| Liposomal amphotericin B and renal safety: review of the evidence and clinical considerations | 2026 | Review article Design not recorded in structured metadata | 7 | cc by PMID 41549663 · DOI · PMC12813295 |
| Exercise and Weekly Sirolimus (Rapamycin) in Older Adults: RAPA-EX-01 Randomised, Double-Blind, Placebo-Controlled Trial | 2026 | Randomized controlled trial Design not recorded in structured metadata | 3 | cc by PMID 41985884 · DOI · PMC13082878 |
Mechanical loading induces the longitudinal growth of muscle fibers via a rapamycin-insensitive mechanism [1]
Abstract reading summary — source excerpts
- Opening excerpt
- Mechanical loading drives skeletal muscle growth, yet the mechanisms that regulate this process remain undefined.
- Closing excerpt
- Collectively, our findings not only challenge the long-standing view that mechanically induced growth is uniformly governed by mTORC1 but also lay the framework for a revised understanding of the molecular and structural events that drive this process.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (147 words)
Mechanical loading drives skeletal muscle growth, yet the mechanisms that regulate this process remain undefined. Here, we show that an increase in mechanical loading induces muscle fiber growth through two distinct mechanisms. Radial growth, reflected by an increase in fiber cross-sectional area, is mediated through a rapamycin-sensitive signaling pathway, whereas longitudinal growth, marked by the in-series addition of sarcomeres, is mediated through a rapamycin-insensitive signaling pathway. To gain further insight into the events that drive longitudinal growth, we combined BONCAT-based labeling of synthesized proteins with high-resolution imaging and determined that the in-series addition of sarcomeres is mediated by a process that involves transverse splitting at the Z-lines of preexisting sarcomeres. Collectively, our findings not only challenge the long-standing view that mechanically induced growth is uniformly governed by mTORC1 but also lay the framework for a revised understanding of the molecular and structural events that drive this process.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41686888 · DOI · PMC12904167
Liposomal amphotericin B and renal safety: review of the evidence and clinical considerations [2]
Abstract reading summary — source excerpts
- Opening excerpt
- Invasive fungal infections continue to represent an important cause of morbidity and mortality in severely ill and immunocompromised patients.
- Closing excerpt
- Alternate dosing strategies, including intermittent dosing and, for certain fungal infections, single-dose high-dose induction therapy, may be useful in minimizing nephrotoxicity, but additional research is necessary.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (166 words)
Invasive fungal infections continue to represent an important cause of morbidity and mortality in severely ill and immunocompromised patients. Liposomal amphotericin B (LAmB) has a significantly improved toxicity profile versus conventional amphotericin B deoxycholate and is recommended for a wide range of medically important opportunistic fungal pathogens. Although rates are significantly lower than with older formulations, nephrotoxicity with LAmB remains a concern. Risk factors for renal toxicity with LAmB include higher doses, longer duration of treatment, concomitant use of nephrotoxic agents and the presence of pre-existing kidney disease. Appropriate patient screening, individualized risk assessment, and patient monitoring may reduce the risk of renal toxicity. The prophylactic use of intravenous saline fluids is also recommended with LAmB to reduce the risk of nephrotoxicity. In addition, magnesium and potassium supplementation should be considered to reduce the risk of hypomagnesaemia and hypokalaemia, respectively. Alternate dosing strategies, including intermittent dosing and, for certain fungal infections, single-dose high-dose induction therapy, may be useful in minimizing nephrotoxicity, but additional research is necessary.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41549663 · DOI · PMC12813295
Exercise and Weekly Sirolimus (Rapamycin) in Older Adults: RAPA-EX-01 Randomised, Double-Blind, Placebo-Controlled Trial [3]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundPreclinical models suggest alternating activation and inhibition of mechanistic target of rapamycin complex 1 (mTORC1) could enhance adaptation to exercise ('cycling hypothesis').
- Closing excerpt
- Trial registrationACTRN12624000790549.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (393 words)
BackgroundPreclinical models suggest alternating activation and inhibition of mechanistic target of rapamycin complex 1 (mTORC1) could enhance adaptation to exercise ('cycling hypothesis'). Whether this concept translates to older adults is unknown. This exploratory trial assessed whether once-weekly sirolimus (rapamycin) 6 mg enhances or inhibits functional gains from a home-based exercise programme.MethodsIn this randomised, double-blind, placebo-controlled trial, 40 sedentary adults aged 65-85 years (mean 72.2 years; 47.5% female) were assigned (1:1) to sirolimus (rapamycin) 6 mg or matched placebo once weekly for 13 weeks. Both groups performed a standardised home-based resistance (chair-stands) and endurance (exercycle) programme three times/week. The primary outcome was the change in 30-s chair-stand repetitions at 13 weeks (intention-to-treat; ANCOVA adjusted for baseline performance, age stratum and sex). Complete-case (CC) and per-protocol (PP) analyses were prespecified sensitivity analyses. Secondary outcomes included grip strength, 6-min walk distance, SF-36 physical and mental component scores, C-reactive protein and several epigenetic age measures. Safety was assessed through adverse-event monitoring and laboratory tests.ResultsBoth groups improved chair-stand performance. The primary intention-to-treat analysis showed an adjusted mean difference (sirolimus-placebo) of -2.13 repetitions (95% CI -4.61 to 0.34; p = 0.089). Sensitivity analyses favoured placebo and reached statistical significance: complete-case analysis (16 sirolimus, 19 placebo) showed a difference of -2.46 repetitions (95% CI -4.87 to -0.06; p = 0.045) and per-protocol analysis (15 sirolimus, 16 placebo) showed -3.44 repetitions (95% CI -5.86 to -0.99; p = 0.007). Secondary functional outcomes also favoured placebo but were not statistically significant: the adjusted mean difference for 6MWD was -4.87 m (95% CI -28.97 to 19.71; p = 0.706) and for grip strength was -1.13 kg (95% CI -3.52 to 1.18; p = 0.344). SF-36 scores showed small, non-significant differences favouring placebo. Quality-of-life scores showed small, non-significant differences favouring placebo. Seventeen participants (85%) in each arm reported ≥ 1 adverse event, but the total burden was higher with sirolimus (99 vs. 63 events), including one possibly drug-related serious adverse event (pneumonia).ConclusionIn this exploratory trial, once-weekly sirolimus (rapamycin) 6 mg did not enhance, and in sensitivity analyses, it may have modestly attenuated short-term functional improvements from a home exercise programme in older adults. The regimen also increased the burden of minor adverse events and may have contributed to one serious infection. Future trials with longer treatment duration or less frequent/lower dosing are needed to determine whether a favourable benefit-risk profile can be achieved.Trial registrationACTRN12624000790549.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41985884 · DOI · PMC13082878
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Effect of hydroxychloroquine with or without azithromycin on the mortality of coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysis [4]
- Research article Prevalence of mutations associated with resistance to macrolides and fluoroquinolones in Mycoplasma genitalium: a systematic review and meta-analysis [5]
- Research article A meta-analysis of short versus long therapy with a proton pump inhibitor, clarithromycin and either metronidazole or amoxycillin for treating Helicobacter pylori infection [6]
- Research article Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines [7]
- Research article Long-term macrolide antibiotics for the treatment of bronchiectasis in adults: an individual participant data meta-analysis [8]
- Research article Tacrolimus trough levels, rejection and renal impairment in liver transplantation: a systematic review and meta-analysis [9]
References
- Hibbert JE, Jorgenson KW, Sayed RKA, Paez HG, Meinhold M, Flynn CGK, et al.. Mechanical loading induces the longitudinal growth of muscle fibers via a rapamycin-insensitive mechanism. . 2026. PMID 41686888 · DOI · PMC12904167
- Maertens J, Birne R, Felton T, Neofytos D, Hoenigl M. Liposomal amphotericin B and renal safety: review of the evidence and clinical considerations. . 2026. PMID 41549663 · DOI · PMC12813295
- Stanfield B, Leroux B, Kaeberlein M, Jones J, Lucas R. Exercise and Weekly Sirolimus (Rapamycin) in Older Adults: RAPA-EX-01 Randomised, Double-Blind, Placebo-Controlled Trial. . 2026. PMID 41985884 · DOI · PMC13082878
- Fiolet T, Guihur A, Rebeaud ME, Mulot M, Peiffer-Smadja N, Mahamat-Saleh Y. Effect of hydroxychloroquine with or without azithromycin on the mortality of coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysis. Clin Microbiol Infect. 2021. PMID 32860962 · DOI · PMC7449662
- Machalek DA, Tao Y, Shilling H, Jensen JS, Unemo M, Murray G, et al.. Prevalence of mutations associated with resistance to macrolides and fluoroquinolones in Mycoplasma genitalium: a systematic review and meta-analysis. Lancet Infect Dis. 2020. PMID 32622378 · DOI
- Calvet X, Calvet X, García N, López T, Gisbert JP, Gené E, et al.. A meta-analysis of short versus long therapy with a proton pump inhibitor, clarithromycin and either metronidazole or amoxycillin for treating Helicobacter pylori infection. Aliment Pharmacol Ther. 2000. PMID 10792124 · DOI
- Bryant A, Lawrie TA, Dowswell T, Fordham EJ, Mitchell S, Hill SR, et al.. Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines. Am J Ther. 2021. PMID 34145166 · DOI · PMC8248252
- Chalmers JD, Boersma W, Lonergan M, Jayaram L, Crichton ML, Karalus N, et al.. Long-term macrolide antibiotics for the treatment of bronchiectasis in adults: an individual participant data meta-analysis. Lancet Respir Med. 2019. PMID 31405828 · DOI
- Rodríguez-Perálvarez M, Germani G, Darius T, Lerut J, Tsochatzis E, Burroughs AK. Tacrolimus trough levels, rejection and renal impairment in liver transplantation: a systematic review and meta-analysis. Am J Transplant. 2012. PMID 22703529 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-31.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.