Contraindications and Cautions Macrolides are contraindicated in patients with a known allergy to any macrolide , Ocular preparations are contraindicated for viral, hepatic dysfunction, use with caution in lactating women because macrolides secreted in breast milk can cause diarrhea and super infections in the infant, and in pregnant women because of potential adverse effects on the developing fetus; use only if the benefit clearly outweighs the risk to the fetus or the infant Drug to Drug: Oral anticoagulants, theophyllines, carbamazepine, or corticosteroids, cycloserine Beta-Lactams - class of broad-spectrum antibiotics , mainly active only against Gram- positive bacteria, yet the recent development of broad-spectrum β-lactam antibiotics active against various Gram-negative organisms has increased their usefulness. Types: penicillin derivatives ( penams ), cephalosporins ( cephems ), monobactams , carbapenems Action: Bacteriocidal , and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls . Adverse effects Common adverse drug reactions for the β-lactam antibiotics include diarrhea, nausea, rash, urticaria , superinfection (including candidiasis ). [3] Infrequent adverse effects include fever, vomiting, erythema , dermatitis, angioedema , pseudomembranous colitis . [3] Pain and inflammation at the injection site is also common for parenterally administered β-lactam antibiotics.