clarithromycin

CHEBI:3732 ·resolve ·ANTIBACTERIAL ·EXACT SEEDED

The 6-O-methyl ether of erythromycin A, clarithromycin is a macrolide antibiotic used in the treatment of respiratory-tract, skin and soft-tissue infections. It is also used to eradicate Helicobacter pylori in the treatment of peptic ulcer disease. It prevents bacteria from growing by interfering with their protein synthesis. — ChEBI

Machine-generated and unreviewed. Identity, structure and cross-references come straight from ChEBI's and CARD's own data; no curator has signed off on this record yet.

Classification

macrolide antibioticARO:0000000

Strictly broader compounds or drug classes this molecule belongs to.

macrolide antibiotic CHEBI:25105
macrolide antibiotic ARO:0000000

Chemical structure

Computed structure properties
Molecular formula	C38H69NO13
Charge	0
Average mass	747.964 Da
Monoisotopic mass	747.47689 Da
Source	ChEBI
InChIKey	AGOYDEPGAOXOCK-KCBOHYOISA-N

SMILES

[H][C@]1(O[C@H]2[C@H](C)[C@@H](O[C@]3([H])O[C@H](C)C[C@H](N(C)C)[C@H]3O)[C@](C)(OC)C[C@@H](C)C(=O)[C@H](C)[C@@H](O)[C@](C)(O)[C@@H](CC)OC(=O)[C@@H]2C)C[C@@](C)(OC)[C@@H](O)[C@H](C)O1

InChI

InChI=1S/C38H69NO13/c1-15-26-38(10,45)31(42)21(4)28(40)19(2)17-37(9,47-14)33(52-35-29(41)25(39(11)12)16-20(3)48-35)22(5)30(23(6)34(44)50-26)51-27-18-36(8,46-13)32(43)24(7)49-27/h19-27,29-33,35,41-43,45H,15-18H2,1-14H3/t19-,20-,21+,22+,23-,24+,25+,26-,27+,29-,30+,31-,32+,33-,35+,36-,37-,38-/m1/s1

Also called

clarithromycina (INN)— chebi
clarithromycine (INN)— chebi
clarithromycinum (INN)— chebi
O6-methylerythromycin (EXACT_SYNONYM)— chebi
6-O-methylerythromycin (EXACT_SYNONYM)— chebi
6-O-methylerythromycin A (EXACT_SYNONYM)— chebi
CLA (EXACT_SYNONYM)— chebi
CLARITHROMYCIN (EXACT_SYNONYM)— chebi
Clarithromycin (EXACT_SYNONYM)— chebi
Biaxin (EXACT_SYNONYM)— aro
CLR (EXACT_SYNONYM)— aro
Clambiotic (EXACT_SYNONYM)— aro
Clarith (EXACT_SYNONYM)— aro
Clathromycin (EXACT_SYNONYM)— aro
Klacid (EXACT_SYNONYM)— aro
Klaricid (EXACT_SYNONYM)— aro
Macladin (EXACT_SYNONYM)— aro
Naxy (EXACT_SYNONYM)— aro
Veclam (EXACT_SYNONYM)— aro

Cross-references

Identifiers for this same structure in other resources. An accession that lands on two different structures in this corpus is withheld from both rather than shown here, since it names at most one of them.

Drug registries

Identifiers that name a drug rather than a structure. One of these can cover a parent compound, its salts and its stereoisomers, which this corpus keeps as separate records, so it is not an equivalence of structure.

Patents and articles

Documents about this compound. A patent covers a class and an article covers a topic; neither identifies a structure.

Activity roles

Every antimicrobial role a source asserts for this compound — the unreduced evidence behind its antimicrobial_class.

antimicrobial agent CHEBI:33281
antibacterial drug CHEBI:36047

Source concepts

Every upstream concept that resolved to this record. The merge is the product: this is what shows ChEBI and CARD are describing the same structure.

Upstream concepts merged into this record
Source	Native ID	Label	Minted CURIE	Version
ARO	`ARO:0000065`	clarithromycin	`antibioticmech:aro-5c92a4ddc8`	2026-08-30
CHEBI	`CHEBI:3732`	clarithromycin	`antibioticmech:chebi-e63133b2eb`	2026-08-30

Molecular targets

The molecular entity or process this compound acts on. Each target carries evidence — this is a mechanistic claim, not a classification.

50S ribosomal subunit P-site RIBOSOMAL_SUBUNIT DIRECT_BINDING_TARGET

ARO:3000757

CARD/ARO database assertion; target organism, strain, and assay are not specified. The 50S P-site is asserted as the target site. Evidence status: PRIMARY_EVIDENCE_NEEDED. Source: CARD_ARO 2026-08-30 (retrieved 2026-08-30).

ARO:3000757 (CARD/ARO asserts targeted_by_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)

Mechanism summary

Mode of action: PROTEIN_SYNTHESIS_INHIBITION microbial target — CURATOR: Confirmed as bacterial 50S macrolide-site inhibition after primary clarithromycin mechanism review. PMID:9425251; PMID:34935599.
Clinical status: APPROVED

Activity spectrum

Measured or curated activity against specific taxa. A number without a method is not an observation — every row here carries an assay.

6 observations · Browse all observations · Complete record (JSON.gz)

Activity observations
Organism	Activity	MIC	Disk diffusion	Assay	Strain	Sample/genome	Evidence
Mycobacterium tuberculosis complex	RESISTANT	—	—	CRyPTIC DST; CLIRES2020; not specified	—	1 source isolates 1 measurements	Evidence Page data (JSON.gz)
Mycobacterium tuberculosis complex	RESISTANT	—	—	CRyPTIC DST; SEQTREAT2020; liquid media; microdilution plate; MYCOTB; critical concentration 0.5 mg/L	—	6 source isolates 6 measurements	Evidence Page data (JSON.gz)
Mycobacterium tuberculosis complex	SUSCEPTIBLE	—	—	CRyPTIC DST; SEQTREAT2020; liquid media; microdilution plate; MYCOTB; critical concentration 0.5 mg/L	—	6 source isolates 6 measurements	Evidence Page data (JSON.gz)
Mycobacterium tuberculosis complex	—	—	—	CRyPTIC DST; SEQTREAT2020; liquid media; microdilution plate; MYCOTB; critical concentration 0.5 mg/L	—	451 source isolates 451 measurements	Evidence Page data (JSON.gz)
Mycobacterium tuberculosis complex	RESISTANT	—	—	CRyPTIC DST; SEQTREAT2020; solid media; middlebrook; 7H10; critical concentration 3.0 mg/L	—	52 source isolates 52 measurements	Evidence Page data (JSON.gz)
Mycobacterium tuberculosis complex	SUSCEPTIBLE	—	—	CRyPTIC DST; SEQTREAT2020; solid media; middlebrook; 7H10; critical concentration 3.0 mg/L	—	21 source isolates 21 measurements	Evidence Page data (JSON.gz)

Resistance mechanisms

54 source-backed resistance determinants or associations, with ARO grounding where reported. Grouped by reported mechanism type.

ANTIBIOTIC_TARGET_ALTERATION 35

ANTIBIOTIC_TARGET_ALTERATION
Determinant	ARO ID	Organism	Gene families	Evidence
Erm(33)	ARO:3000599	not organism-specific	—	ARO:3000599 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Erm(34)	ARO:3000600	not organism-specific	—	ARO:3000600 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Erm(35)	ARO:3000604	not organism-specific	—	ARO:3000604 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Erm(36)	ARO:3000605	not organism-specific	—	ARO:3000605 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Erm(37)	ARO:3000392	not organism-specific	—	ARO:3000392 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Erm(38)	ARO:3000601	not organism-specific	—	ARO:3000601 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Erm(39)	ARO:3000602	not organism-specific	—	ARO:3000602 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Erm(41)	ARO:3000603	not organism-specific	—	ARO:3000603 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Erm(50)	ARO:3007032	not organism-specific	—	ARO:3007032 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Erm(51)	ARO:3007033	not organism-specific	—	ARO:3007033 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
ErmA	ARO:3000347	not organism-specific	—	ARO:3000347 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
ErmB	ARO:3000375	not organism-specific	—	ARO:3000375 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
ErmC	ARO:3000250	not organism-specific	—	ARO:3000250 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
ErmD	ARO:3000495	not organism-specific	—	ARO:3000495 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
ErmE	ARO:3000326	not organism-specific	—	ARO:3000326 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
ErmF	ARO:3000498	not organism-specific	—	ARO:3000498 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
ErmG	ARO:3000522	not organism-specific	—	ARO:3000522 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
ErmN	ARO:3000592	not organism-specific	—	ARO:3000592 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
ErmQ	ARO:3000593	not organism-specific	—	ARO:3000593 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
ErmR	ARO:3000594	not organism-specific	—	ARO:3000594 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
ErmT	ARO:3000595	not organism-specific	—	ARO:3000595 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
ErmX	ARO:3000596	not organism-specific	—	ARO:3000596 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Escherichia coli 23S rRNA with mutation conferring resistance to clarithromycin	ARO:3004160	not organism-specific	—	ARO:3004160 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Helicobacter pylori 23S rRNA with mutation conferring resistance to clarithromycin	ARO:3004134	not organism-specific	—	ARO:3004134 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Mycobacterium avium 23S rRNA with mutation conferring resistance to clarithromycin	ARO:3004164	not organism-specific	—	ARO:3004164 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Mycobacterium intracellulare 23S rRNA with mutation conferring resistance to clarithromycin	ARO:3004166	not organism-specific	—	ARO:3004166 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Mycobacterium kansasii 23S rRNA with mutation conferring resistance to clarithromycin	ARO:3004168	not organism-specific	—	ARO:3004168 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Mycobacteroides abscessus 23S rRNA with mutation conferring resistance to clarithromycin	ARO:3004163	not organism-specific	—	ARO:3004163 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Mycobacteroides chelonae 23S rRNA with mutation conferring resistance to clarithromycin	ARO:3004165	not organism-specific	—	ARO:3004165 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Mycolicibacterium smegmatis 23S rRNA with mutation conferring resistance to clarithromycin	ARO:3004169	not organism-specific	—	ARO:3004169 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Mycoplasma hominis 23S rRNA with mutation conferring resistance to macrolide antibiotics	ARO:3004176	not organism-specific	—	ARO:3004176 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
Mycoplasmopsis fermentans 23S rRNA with mutation conferring resistance to macrolide antibiotics	ARO:3004177	not organism-specific	—	ARO:3004177 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
erm(40)	ARO:3004606	not organism-specific	—	ARO:3004606 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
erm(46)	ARO:3004596	not organism-specific	—	ARO:3004596 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
erm(55)	ARO:3009647	not organism-specific	—	ARO:3009647 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)

UNKNOWN 10

UNKNOWN
Determinant	ARO ID	Organism	Gene families	Evidence
erm(55)-associated clarithromycin resistance in clinical isolate 18:60630 Same-isolate gene-family/phenotype co-occurrence, not proof of allele-specific causation. The paper uses the verified species synonym Mycobacterium chelonae. The corrected table distinguishes different erm(55) subtypes; they are not all positive for the same subtype-specific assay. The separate susceptible comparator and intermediate isolates are not included in these resistance claims. No exact allele, UniProt accession, strain TaxID, genome or numerical AST is assigned. Compound scope follows the study's named clarithromycin assay; the tested preparation was not independently re-identified.	—	Mycobacteroides chelonae `NCBITaxon:1774` strain 18:60630	erm(55)	PMID:37347171 (Primary clinical-isolate study; observational association, not a functional gene experiment.) PMID:38572983 (Corrected Table 2 replaces the misaligned genotype columns. Publisher HTML table text inspected; native PDF unavailable after HTTP 403, with no retry or bypass.) Source-reported broth microdilution phenotype
erm(55)-associated clarithromycin resistance in clinical isolate 18:62378 Same-isolate gene-family/phenotype co-occurrence, not proof of allele-specific causation. The paper uses the verified species synonym Mycobacterium chelonae. The corrected table distinguishes different erm(55) subtypes; they are not all positive for the same subtype-specific assay. The separate susceptible comparator and intermediate isolates are not included in these resistance claims. No exact allele, UniProt accession, strain TaxID, genome or numerical AST is assigned. Compound scope follows the study's named clarithromycin assay; the tested preparation was not independently re-identified.	—	Mycobacteroides chelonae `NCBITaxon:1774` strain 18:62378	erm(55)	PMID:37347171 (Primary clinical-isolate study; observational association, not a functional gene experiment.) PMID:38572983 (Corrected Table 2 replaces the misaligned genotype columns. Publisher HTML table text inspected; native PDF unavailable after HTTP 403, with no retry or bypass.) Source-reported broth microdilution phenotype
erm(55)-associated clarithromycin resistance in clinical isolate 19:64973 Same-isolate gene-family/phenotype co-occurrence, not proof of allele-specific causation. The paper uses the verified species synonym Mycobacterium chelonae. The corrected table distinguishes different erm(55) subtypes; they are not all positive for the same subtype-specific assay. The separate susceptible comparator and intermediate isolates are not included in these resistance claims. No exact allele, UniProt accession, strain TaxID, genome or numerical AST is assigned. Compound scope follows the study's named clarithromycin assay; the tested preparation was not independently re-identified.	—	Mycobacteroides chelonae `NCBITaxon:1774` strain 19:64973	erm(55)	PMID:37347171 (Primary clinical-isolate study; observational association, not a functional gene experiment.) PMID:38572983 (Corrected Table 2 replaces the misaligned genotype columns. Publisher HTML table text inspected; native PDF unavailable after HTTP 403, with no retry or bypass.) Source-reported broth microdilution phenotype
erm(55)-associated clarithromycin resistance in clinical isolate 20:67831 Same-isolate gene-family/phenotype co-occurrence, not proof of allele-specific causation. The paper uses the verified species synonym Mycobacterium chelonae. The corrected table distinguishes different erm(55) subtypes; they are not all positive for the same subtype-specific assay. The separate susceptible comparator and intermediate isolates are not included in these resistance claims. No exact allele, UniProt accession, strain TaxID, genome or numerical AST is assigned. Compound scope follows the study's named clarithromycin assay; the tested preparation was not independently re-identified.	—	Mycobacteroides chelonae `NCBITaxon:1774` strain 20:67831	erm(55)	PMID:37347171 (Primary clinical-isolate study; observational association, not a functional gene experiment.) PMID:38572983 (Corrected Table 2 replaces the misaligned genotype columns. Publisher HTML table text inspected; native PDF unavailable after HTTP 403, with no retry or bypass.) Source-reported broth microdilution phenotype
erm(55)-associated clarithromycin resistance in clinical isolate 20:69984 Same-isolate gene-family/phenotype co-occurrence, not proof of allele-specific causation. The paper uses the verified species synonym Mycobacterium chelonae. The corrected table distinguishes different erm(55) subtypes; they are not all positive for the same subtype-specific assay. The separate susceptible comparator and intermediate isolates are not included in these resistance claims. No exact allele, UniProt accession, strain TaxID, genome or numerical AST is assigned. Compound scope follows the study's named clarithromycin assay; the tested preparation was not independently re-identified.	—	Mycobacteroides chelonae `NCBITaxon:1774` strain 20:69984	erm(55)	PMID:37347171 (Primary clinical-isolate study; observational association, not a functional gene experiment.) PMID:38572983 (Corrected Table 2 replaces the misaligned genotype columns. Publisher HTML table text inspected; native PDF unavailable after HTTP 403, with no retry or bypass.) Source-reported broth microdilution phenotype
erm(55)-associated clarithromycin resistance in clinical isolate 21:70135 Same-isolate gene-family/phenotype co-occurrence, not proof of allele-specific causation. The paper uses the verified species synonym Mycobacterium chelonae. The corrected table distinguishes different erm(55) subtypes; they are not all positive for the same subtype-specific assay. The separate susceptible comparator and intermediate isolates are not included in these resistance claims. No exact allele, UniProt accession, strain TaxID, genome or numerical AST is assigned. Compound scope follows the study's named clarithromycin assay; the tested preparation was not independently re-identified.	—	Mycobacteroides chelonae `NCBITaxon:1774` strain 21:70135	erm(55)	PMID:37347171 (Primary clinical-isolate study; observational association, not a functional gene experiment.) PMID:38572983 (Corrected Table 2 replaces the misaligned genotype columns. Publisher HTML table text inspected; native PDF unavailable after HTTP 403, with no retry or bypass.) Source-reported broth microdilution phenotype
erm(55)-associated clarithromycin resistance in clinical isolate 21:70968 Same-isolate gene-family/phenotype co-occurrence, not proof of allele-specific causation. The paper uses the verified species synonym Mycobacterium chelonae. The corrected table distinguishes different erm(55) subtypes; they are not all positive for the same subtype-specific assay. The separate susceptible comparator and intermediate isolates are not included in these resistance claims. No exact allele, UniProt accession, strain TaxID, genome or numerical AST is assigned. Compound scope follows the study's named clarithromycin assay; the tested preparation was not independently re-identified.	—	Mycobacteroides chelonae `NCBITaxon:1774` strain 21:70968	erm(55)	PMID:37347171 (Primary clinical-isolate study; observational association, not a functional gene experiment.) PMID:38572983 (Corrected Table 2 replaces the misaligned genotype columns. Publisher HTML table text inspected; native PDF unavailable after HTTP 403, with no retry or bypass.) Source-reported broth microdilution phenotype
erm(55)-associated clarithromycin resistance in clinical isolate 21:71627 Same-isolate gene-family/phenotype co-occurrence, not proof of allele-specific causation. The paper uses the verified species synonym Mycobacterium chelonae. The corrected table distinguishes different erm(55) subtypes; they are not all positive for the same subtype-specific assay. The separate susceptible comparator and intermediate isolates are not included in these resistance claims. No exact allele, UniProt accession, strain TaxID, genome or numerical AST is assigned. Compound scope follows the study's named clarithromycin assay; the tested preparation was not independently re-identified.	—	Mycobacteroides chelonae `NCBITaxon:1774` strain 21:71627	erm(55)	PMID:37347171 (Primary clinical-isolate study; observational association, not a functional gene experiment.) PMID:38572983 (Corrected Table 2 replaces the misaligned genotype columns. Publisher HTML table text inspected; native PDF unavailable after HTTP 403, with no retry or bypass.) Source-reported broth microdilution phenotype
erm(55)-associated clarithromycin resistance in clinical isolate 21:73373 Same-isolate gene-family/phenotype co-occurrence, not proof of allele-specific causation. The paper uses the verified species synonym Mycobacterium chelonae. The corrected table distinguishes different erm(55) subtypes; they are not all positive for the same subtype-specific assay. The separate susceptible comparator and intermediate isolates are not included in these resistance claims. No exact allele, UniProt accession, strain TaxID, genome or numerical AST is assigned. Compound scope follows the study's named clarithromycin assay; the tested preparation was not independently re-identified.	—	Mycobacteroides chelonae `NCBITaxon:1774` strain 21:73373	erm(55)	PMID:37347171 (Primary clinical-isolate study; observational association, not a functional gene experiment.) PMID:38572983 (Corrected Table 2 replaces the misaligned genotype columns. Publisher HTML table text inspected; native PDF unavailable after HTTP 403, with no retry or bypass.) Source-reported broth microdilution phenotype
erm(55)-associated clarithromycin resistance in clinical isolate MC6 22:74950 Same-isolate gene-family/phenotype co-occurrence, not proof of allele-specific causation. The paper uses the verified species synonym Mycobacterium chelonae. The corrected table distinguishes different erm(55) subtypes; they are not all positive for the same subtype-specific assay. The separate susceptible comparator and intermediate isolates are not included in these resistance claims. No exact allele, UniProt accession, strain TaxID, genome or numerical AST is assigned. Compound scope follows the study's named clarithromycin assay; the tested preparation was not independently re-identified.	—	Mycobacteroides chelonae `NCBITaxon:1774` strain MC6 22:74950	erm(55)	PMID:37347171 (Primary clinical-isolate study; observational association, not a functional gene experiment.) PMID:38572983 (Corrected Table 2 replaces the misaligned genotype columns. Publisher HTML table text inspected; native PDF unavailable after HTTP 403, with no retry or bypass.) Source-reported broth microdilution phenotype

ANTIBIOTIC_INACTIVATION 8

ANTIBIOTIC_INACTIVATION
Determinant	ARO ID	Organism	Gene families	Evidence
EreA	ARO:3000361	not organism-specific	—	ARO:3000361 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
EreB	ARO:3000363	not organism-specific	—	ARO:3000363 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
mphA	ARO:3000316	not organism-specific	—	ARO:3000316 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
mphB	ARO:3000318	not organism-specific	—	ARO:3000318 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
mphC	ARO:3000319	not organism-specific	—	ARO:3000319 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
mphF	ARO:3003071	not organism-specific	—	ARO:3003071 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
mphG	ARO:3003742	not organism-specific	—	ARO:3003742 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)
mphL	ARO:3003072	not organism-specific	—	ARO:3003072 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)

ANTIBIOTIC_EFFLUX 1

ANTIBIOTIC_EFFLUX
Determinant	ARO ID	Organism	Gene families	Evidence
lmrP	ARO:3003969	not organism-specific	—	ARO:3003969 (CARD/ARO asserts confers_resistance_to_antibiotic ARO:0000065 (clarithromycin); database assertion, not a primary citation.)

Causal graphs

Evidence-backed mechanism graphs: how the compound reaches its target, what the target does, and how the effect propagates to growth inhibition or death.

Clarithromycin blocks the bacterial 50S exit tunnel MECHANISTIC

Clarithromycin binds the macrolide site in the bacterial 50S nascent-peptide exit tunnel, restricting translation elongation and reducing protein synthesis.

Nodes — clarithromycin_50s_exit_tunnel_inhibition
Node	Label	Type	Grounding
`clarithromycin`	clarithromycin	COMPOUND	`CHEBI:3732`
`ribosomal_50s_macrolide_site`	bacterial 50S nascent-peptide exit tunnel macrolide site	RNA	REVIEWED_LABEL_ONLY
`clarithromycin_bound_50s`	clarithromycin-bound 50S exit tunnel	STATE	REVIEWED_LABEL_ONLY
`translation_elongation`	bacterial translation elongation	BIOLOGICAL_PROCESS	REVIEWED_LABEL_ONLY
`protein_synthesis`	bacterial protein synthesis	BIOLOGICAL_PROCESS	REVIEWED_LABEL_ONLY

Edges — clarithromycin_50s_exit_tunnel_inhibition
Subject	Predicate	Object	Evidence
`clarithromycin`	binds	`clarithromycin_bound_50s`	PMID:34935599 (Zhang and colleagues resolved Mycobacterium tuberculosis 50S subunits with bound clarithromycin and observed drug interactions in the 50S tunnel.)
`ribosomal_50s_macrolide_site`	participates in	`clarithromycin_bound_50s`	PMID:34935599 (The clarithromycin-bound 50S cryo-EM structure localizes the drug in the mycobacterial large-subunit exit tunnel.)
`clarithromycin_bound_50s`	decreases	`translation_elongation`	PMID:9425251 (Champney and Burdine measured clarithromycin-dependent inhibition of translation in Staphylococcus aureus cells.)
`translation_elongation`	supports	`protein_synthesis`	PMID:9425251 (The cellular clarithromycin study measured translation inhibition as a protein-synthesis endpoint.)

Curation history

SEEDED_FROM_SOURCES 2026-08-30 · seed_from_sources
Seeded from data/raw/ inventories (ARO, CHEBI)
RESEEDED_FROM_SOURCES 2026-08-30 · seed_from_sources
Re-seeded from updated data/raw/ inventories
RESEEDED_FROM_SOURCES 2026-08-30 · seed_from_sources
Re-seeded from updated data/raw/ inventories
RESEEDED_FROM_SOURCES 2026-08-31 · seed_from_sources
Re-seeded from updated data/raw/ inventories
RESEEDED_FROM_SOURCES 2026-08-31 · seed_from_sources
Re-seeded from updated data/raw/ inventories
RESEEDED_FROM_SOURCES 2026-08-31 · seed_from_sources
Re-seeded from updated data/raw/ inventories
CURATED_CAUSAL_GRAPH 2026-09-04 · codex · LLM-assisted
Added a PMID-supported causal graph for clarithromycin binding to the bacterial 50S macrolide site.
RESEEDED_FROM_SOURCES 2026-09-10 · seed_from_sources
Re-seeded from updated data/raw/ inventories
RESEEDED_FROM_SOURCES 2026-09-26 · seed_from_sources
Re-seeded; changed: activity_spectrum (CRYPTIC 3.4.0). Upstream retrieval date 2026-08-30, unchanged.
RESEEDED_FROM_SOURCES 2026-10-05 · seed_from_sources
Re-seeded; changed: activity_membership_collections (CRYPTIC 3.4.0). Upstream retrieval date 2026-08-30, unchanged.
CURATED_RESISTANCE_EVIDENCE 2026-10-10 · codex · LLM-assisted
Added ten clinical-isolate erm(55)/clarithromycin co-occurrence claims using corrected primary Table 2; grounded the verified species synonym while withholding exact alleles and protein identifiers. Preserved all source-owned content and negative-comparator distinctions. Whole-record review remains open.

Provenance

Seeded by scripts/seed_from_sources.py from the committed inventories in data/raw/. View the record (YAML).

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