Chinese Journal of Organic Chemistry     Next Articles

REVIEW

抗耐药菌红霉素的结构修饰策略、构效关系及全合成研究进展

崔心怡a, 郭丽帆a, 马聪璇*,a, 李耘*,b, 梁建华*,a   

  1. a北京理工大学化学与化工学院 医药分子科学与制剂工程工信部重点实验室 北京 102488
    b北京大学第一医院临床药理研究所 北京 100034
  • 收稿日期:2025-08-08 修回日期:2025-09-05
  • 基金资助:
    国家自然科学基金(No. 22577009)、四川省科技计划项目(2024YFHZ0046)、国家资助博士后研究人员计划(GZC20252723)资助项目.

Structural Modifications, Structure-Activity Relationships, and Total Synthesis Advances in Erythromycin Analogs against Resistant Pathogens

Cui, Xinyia, Guo, Lifana, Ma, Congxuan*,a, Li, Yun*,b, Liang, Jianhua*,a   

  1. aKey Laboratory of Medicinal Molecule Science and Pharmaceutical Engineering, School of Chemistry and Chemical Engineering, Beijing Institute of Technology, Beijing 102488
    bInstitute of Clinical Pharmacology, Peking University First Hospital, Beijing 100034
  • Received:2025-08-08 Revised:2025-09-05
  • Contact: *E-mail: ljhbit@bit.edu.cn; 7520250060@bit.edu.cn; liyun19702@sina.com.
  • Supported by:
    National Natural Science Foundation of CHINA (No. 22577009) and Sichuan Science and Technology Program (2024YFHZ0046) and Postdoctoral Fellowship Program of CPSF (GZC20252723).

Macrolide antibiotics (Macrolide) as clinically important and widely used drugs, by virtue of its broad-spectrum antimicrobial properties and excellent therapeutic efficacy, such as erythromycin, clarithromycin and azithromycin, the essential medicines recommended by the World Health Organization (WHO). However, the emergence of bacterial resistance has significantly reduced their antibacterial efficacy, leaving the treatment of numerous diseases facing a dilemma of no effective drugs available. In particular, macrolide antibiotics, the 3rd-generation telithromycin and 4th-generation solithromycin included, are difficult to exert therapeutic effects against infectious diseases caused by constitutive erm-carrying Staphylococcus aureus, constitutive erm-carrying Streptococcus pyogenes, and Mycoplasma pneumoniae with A2058 mutation. To overcome the problem of bacterial resistance to macrolide antibiotics and further enhance their antibacterial activity against drug-resistant bacteria, researchers have carried out extensive studies on new structures. This review takes the development history of macrolide antibiotics as a chronological framework, systematically summarizing the research progress of these drugs against drug-resistant bacteria from 2013 to 2024. It focuses on elaborating the structure-activity relationships of new structures, pharmacokinetic characteristics, and total synthesis strategies of non-natural macrolides, and summarizes the key breakthroughs of 5th-generation macrolide antibiotics in combating bacterial resistance. This review will provide guidance for subsequent drug design, research on resistance mechanisms, and the development of novel antibacterial strategies.

Key words: macrolides, drug resistance, structural modification, structure-activity relationship, total synthesis