Erythromycin is the first macrolide antibiotic discovered, and it has been used since 1952 in the United States. Suitable for g? Its antibacterial effect on+cocci and pathogens causing atypical pneumonia makes it a suitable substitute for the treatment of upper and lower respiratory tract and soft tissue infections in patients with penicillin allergy. However, erythromycin has several important defects, such as irregular absorption, instability in gastric acid, short elimination half-life, gastrointestinal irritation and narrow antibacterial spectrum, and obviously has no antibacterial activity against Haemophilus influenzae.

It was not until the mid-1980s that the pharmacological and microbiological properties of macrolides were significantly improved.

Early changes include adding various ester structures to improve absorption and gastrointestinal irritation, but new compounds (such as trienomycin, erythromycin lactobionate, moxifloxacin and terdomycin) are not obviously different from erythromycin.

The emergence of AIDS, the increasing popularity of intracellular pathogens and the success of 1975 erythromycin in the treatment of Legionella infection have aroused people's interest in macrolides, and some drugs with new pharmacokinetic properties have appeared in the research and development process. New macrolides with strong acid hydrolysis resistance include clarithromycin, azithromycin and dirithromycin.