In vitro evaluation of three new macrolide antimicrobial agents, RU28965, RU29065, and RU29702, and comparisons with other orally administered drugs.

Three new macrolide drugs (RU28965, RU29065, and RU29702) were compared in vitro with erythromycin and five other orally administered antimicrobial agents by using 733 recent clinical isolates. All of the investigational macrolides had a spectrum very similar to that of erythromycin, but with slightly higher (two- to fourfold) minimum inhibitory concentrations against Haemophilus influenzae, staphylococci, and streptococci including Streptococcus faecalis. RU29065 and RU29702 were more active than erythromycin against Neisseria gonorrhoeae and Neisseria meningitidis. The drugs appeared to be predominantly bacteriostatic and were ineffective against gram-negative bacilli, and their minimum inhibitory concentrations were greatly increased by high inoculum concentrations. Cross-resistance between the macrolides was nearly complete, favoring the use of a single agent for in vitro susceptibility test if in vivo therapeutic differences are not observed.