Macrolides · Pharmacology

Why should macrolides be avoided in patients with a history of Myasthenia Gravis?

  1. They can cause severe hepatotoxicity
  2. They may exacerbate muscle weakness and trigger a myasthenic crisis
  3. They interfere with the metabolism of Pyridostigmine
  4. They increase the risk of tendon rupture
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Correct answer: They may exacerbate muscle weakness and trigger a myasthenic crisis

Macrolides, especially telithromycin and azithromycin, have been reported to exacerbate symptoms of myasthenia gravis. The mechanism is not fully understood but may involve interference with neuromuscular transmission.

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