General properties of macrolides 8. Resistance mechanism: (1)modification of the ribosomal binding site (2) production of esterase that hydrolyze macrolides (3 reduced permeability of cell membrane or active efflux (4)Ribosome mutation(base mutation of 23s rRNA or ribosome protein mutation) Cross-resistance is complete between erythromycin and the other macrolides8. Resistance mechanism: (1) modification of the ribosomal binding site (2) production of esterase that hydrolyze macrolides (3) reduced permeability of cell membrane or active efflux (4) Ribosome mutation (base mutation of 23s rRNA or ribosome protein mutation) ***Cross-resistance is complete between erythromycin and the other macrolides. General properties of macrolides