farmaecFARMAKOEKONOMIKA. Modern Pharmacoeconomics and PharmacoepidemiologyФАРМАКОЭКОНОМИКА. Современная фармакоэкономика и фармакоэпидемиология2070-49092070-4933IRBIS LLC10.17749/2070-4909/farmakoekonomika.2026.353farmaec-1377Research ArticleORIGINAL ARTICLESОРИГИНАЛЬНЫЕ ПУБЛИКАЦИИSystematic computer analysis of fundamental and clinical studies on spiramycin pharmacologyСистематический компьютерный анализ фундаментальных и клинических исследований фармакологии спирамицинаhttps://orcid.org/0000-0002-2659-7998ТоршинИ. Ю.TorshinI. Yu.

Торшин Иван Юрьевич, к.ф-м.н., к.х.н.

WoS ResearcherID: C-7683-2018. Scopus Author ID: 7003300274

ул. Вавилова, д. 44, корп. 2, Москва 119333

Ivan Yu. Torshin, PhD

WoS ResearcherID: C-7683-2018. Scopus Author ID: 7003300274

44 corp. 2 Vavilov Str., Moscow 119333

https://orcid.org/0000-0002-7663-710XГромоваО. А.GromovаO. A.

Громова Ольга Алексеевна, д.м.н., проф.

WoS ResearcherID: J-4946-2017. Scopus Author ID:  7003589812

ул. Вавилова, д. 44, корп. 2, Москва 119333

Olga A. Gromova, Dr. Sci. Med., Prof.

WoS ResearcherID: J-4946-2017. Scopus Author ID: 7003589812

44 corp. 2 Vavilov Str., Moscow 119333

unesco.gromova@gmail.comhttps://orcid.org/0000-0001-7507-191XГромовА. Н.GromovA. N.

Громов Андрей Николаевич

WoS ResearcherID: C-7476-2018. Scopus Author ID: 7102053964

ул. Вавилова, д. 44, корп. 2, Москва 119333

Andrey N. Gromov

WoS ResearcherID: C-7476-2018. Scopus Author ID: 7102053964

44 corp. 2 Vavilov Str., Moscow 119333

https://orcid.org/0000-0002-8958-6495СемёновВ. А.SemenovV. A.

Семёнов Владимир Александрович, д.м.н., проф.

ул. Ворошилова, д. 22а, Кемерово 650056

Vladimir A. Semenov, Dr. Sci. Med., Prof.

22а Voroshilov Str., Kemerovo 650056

Федеральный исследовательский центр «Информатика и управление» Российской академии наукРоссияFederal Research Center “Computer Science and Control”, Russian Academy of SciencesRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Кемеровский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияKemerovo State Medical UniversityRussian Federation2026070520261195067Copyright © Torshin I.Y., Gromovа O.A., Gromov A.N., Semenov V.A., 20262026Торшин И.Ю., Громова О.А., Громов А.Н., Семёнов В.А.Torshin I.Y., Gromovа O.A., Gromov A.N., Semenov V.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pharmacoeconomics.ru/jour/article/view/1377

Background. Spiramycin is a macrolide antibiotic characterized by minimal resistance to various strains of pathogenic bacteria and a good safety profile. Although the pharmacology of spiramycin has been the subject of many publications, these data are yet to be systematized.Objective: To systematize all available scientific publications on spiramycin pharmacology.Material and methods. All currently available publications on basic and clinical studies of spiramycin were analyzed. The query “spiramycin OR rovamycine OR RP 5337” returned 1,755 reports in the PubMed/MEDLINE biomedical database. This sample of publications was then systematically analyzed using the topological and metric approaches to the analysis of heterogeneous feature descriptions that are adopted by the scientific school of Yu.I. Zhuravlev and K.V. Rudakov (Academicians of the RAS). Results. A cluster analysis of the most informative terms describing the pharmacological properties of spiramycin revealed that it is a unique macrolide characterized by targeted tissue accumulation and significantly higher safety than other antibiotics. This safety of spiramycin underlies its successful use to treat toxoplasmosis in pregnant women and prevent maternal-to-fetal transmission of the parasite Toxoplasma gondii. Spiramycin also holds promise for the treatment of other urogenital infections (chlamydia and non-gonococcal urethritis), as well as against oral pathogens that cause caries, gingivitis, and periodontitis. Spiramycin's targeted accumulation in lung tissue allows it to be used against respiratory pathogens, including upper and lower respiratory tract infections. Spiramycin was shown to have anti-inflammatory, anti-tumor, and other additional effects (e.g., anti-obesity).Conclusion. Spiramycin is characterized by targeted tissue accumulation; it exhibits no significant concomitant toxicity, causes no micronutrient loss (including magnesium, whose deficiency results in QT interval prolongation on the electrocardiogram), and, unlike some other macrolides, has no stimulating effect on resistance development in bacterial pathogens. These properties of the spiramycin molecule indicate promising potential for its use in the inhibition and eradication of bacterial strains resistant to other antibiotics.

Актуальность. Спирамицин – антибиотик ряда макролидов, характеризующийся минимальной резистентностью к различным штаммам патогенных бактерий и хорошим профилем безопасности. Существует множество публикаций по фармакологии спирамицина, но систематизации этого массива научных данных ранее не проводилось.Цель: систематизация всех имеющихся научных публикаций по фармакологии спирамицина.Материал и методы. Изучены все существующие на данный момент публикации по фундаментальным и клиническим исследованиям спирамицина. По запросу “spiramycin OR rovamycine OR RP 5337” в научной биомедицинской базе PubMed/MEDLINE найдено 1755 записей. После загрузки данной выборки проведен систематический анализ этого массива публикаций с использованием топологического и метрического подходов научной школы академиков РАН Ю.И. Журавлёва и К.В. Рудакова к анализу разнородных признаковых описаний.Результаты. Кластерный анализ наиболее информативных терминов, описывающих фармакологические свойства спирамицина, показал, что препарат является уникальной разновидностью макролидов, характеризующейся таргетным накоплением в тканях и отличающейся гораздо более высокой безопасностью, чем другие антибиотики. Именно безопасность спирамицина обусловливает успешность его использования для терапии токсоплазмоза беременных и профилактики передачи паразита Toxoplasma gondii от беременной к плоду. Перспективно применение спирамицина и в терапии других урогенитальных инфекций (хламидиоза, негонококкового уретрита), а также против патогенов полости рта, вызывающих кариес, гингивит и периодонтит (пародонтит). Таргетное накопление спирамицина в легочной ткани позволяет использовать его против патогенов, поражающих дыхательную систему, в т.ч. при инфекциях верхних и нижних дыхательных путей. Установлены противовоспалительные, противоопухолевые и другие дополнительные эффекты спирамицина (например, противодействие ожирению).Заключение. Спирамицин отличается таргетным накоплением в тканях, не проявляет серьезной сопутствующей токсичности, не способствует потерям микронутриентов (в т.ч. магния, дефицит которого стимулирует удлинение интервала QT кардиограммы) и, в отличие от некоторых других макролидов, не стимулирует развитие резистентности у бактериальных патогенов. Эти особенности молекулы спирамицина указывают на хорошие перспективы его применения для ингибирования и эрадикации бактериальных штаммов, резистентных к другим антибиотикам.

антибиотикотерапияспирамицинэффективность и безопасностьфармакоинформатикаинтеллектуальный анализ данныхДорамитцин ВМantibiotic therapyspiramycinefficacy and safetypharmacoinformaticsdata miningDoramitcin WMReferencesKum E., İnce E. Metabolomics approach to explore bioactive natural products derived from plant-root-associated streptomyces. Appl Biochem Biotechnol. 2024; 196 (10): 7293–306. https://doi.org/10.1007/s12010-024-04905-7.Kum E., İnce E. Metabolomics approach to explore bioactive natural products derived from plant-root-associated streptomyces. Appl Biochem Biotechnol. 2024; 196 (10): 7293–306. https://doi.org/10.1007/s12010-024-04905-7.Parker C.T., Garrity G.M. Nomenclature Abstract for Streptomyces ambofaciens Pinnert-Sindico 1954 (Approved Lists 1980) emend. Nouioui et al. 2018. https://doi.org/10.1601/nm.6849.Parker C.T., Garrity G.M. Nomenclature Abstract for Streptomyces ambofaciens Pinnert-Sindico 1954 (Approved Lists 1980) emend. Nouioui et al. 2018. https://doi.org/10.1601/nm.6849.Cosar C., Ninet L., Pinnert-Sindico S., Preud'Homme J. Trypanocide action of an antibiotic produced by a streptomyces. C R Hebd Seances Acad Sci. 1952; 234 (14): 1498–9 (in French).Cosar C., Ninet L., Pinnert-Sindico S., Preud'Homme J. Trypanocide action of an antibiotic produced by a streptomyces. C R Hebd Seances Acad Sci. 1952; 234 (14): 1498–9 (in French).Kavi J., Webberley J.M., Andrews J.M., Wise R. A comparison of the pharmacokinetics and tissue penetration of spiramycin and erythromycin. J Antimicrob Chemother. 1988; 22 (Suppl B): 105–10. https://doi.org/10.1093/jac/22.supplement_b.105.Kavi J., Webberley J.M., Andrews J.M., Wise R. A comparison of the pharmacokinetics and tissue penetration of spiramycin and erythromycin. J Antimicrob Chemother. 1988; 22 (Suppl B): 105–10. https://doi.org/10.1093/jac/22.supplement_b.105.Ardila C.M., Bedoya-García J.A. Antimicrobial resistance in patients with odontogenic infections: a systematic scoping review of prospective and experimental studies. J Clin Exp Dent. 2022; 14 (10): e834-45. https://doi.org/10.4317/jced.59830.Ardila C.M., Bedoya-García J.A. Antimicrobial resistance in patients with odontogenic infections: a systematic scoping review of prospective and experimental studies. J Clin Exp Dent. 2022; 14 (10): e834-45. https://doi.org/10.4317/jced.59830.Torshin I.Yu. On solvability, regularity, and locality of the problem of genome annotation. Pattern Recognit Image Anal. 2010; 20: 386–95. https://doi.org/10.1134/S1054661810030156.Torshin I.Yu. On solvability, regularity, and locality of the problem of genome annotation. Pattern Recognit Image Anal. 2010; 20: 386–95. https://doi.org/10.1134/S1054661810030156.Громова О.А., Торшин И.Ю., Кобалава Ж.Д. и др. Дефицит магния и гиперкоагуляционные состояния: метрический анализ данных выборки пациентов 18–50 лет лечебно-профилактических учреждений России. Кардиология. 2018; 58 (4): 22–35. https://doi.org/10.18087/cardio.2018.4.10106.Gromova O.A., Torshin I.Yu., Kobalava Zh.D., et al. Deficit of magnesium and states of hypercoagulation: intellectual analysis of data obtained from a sample of patients aged 18–50 years from medical and preventive facilities in Russia. Kardiologiia. 2018; 58 (4): 22–35 (in Russ.). https://doi.org/10.18087/cardio.2018.4.10106.Торшин И.Ю., Громова О.А., Стаховская Л.В. и др. Анализ 19,9 млн публикаций базы данных PubMed/MEDLINE методами искусственного интеллекта: подходы к обобщению накопленных данных и феномен “fake news”. ФАРМАКОЭКОНОМИКА. Современная фармакоэкономика и фармакоэпидемиология. 2020; 13 (2): 146–63. https://doi.org/10.17749/2070-4909/farmakoekonomika.2020.021.Torshin I.Yu., Gromova O.A., Stakhovskaya L.V., et al. Analysis of 19.9 million publications from the PubMed/MEDLINE database using artificial intelligence methods: approaches to the generalizations of accumulated data and the phenomenon of “fake news”. FARMAKOEKONOMIKA. Sovremennaya farmakoekonomika i farmakoepidemiologiya / FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2020; 13 (2): 146–63 (in Russ.). https://doi.org/10.17749/2070-4909/farmakoekonomika.2020.021.Торшин И.Ю. О задачах оптимизации, возникающих при применении топологического анализа данных к поиску алгоритмов прогнозирования с фиксированными корректорами. Информатика и ее применения. 2023; 17 (2): 2–10. https://doi.org/10.14357/19922264230201.Torshin I.Yu. On optimization problems arising from the application of topological data analysis to the search for forecasting algorithms with fixed correctors. Informatics and Applications. 2023; 17 (2): 2–10 (in Russ.). https://doi.org/10.14357/19922264230201.Торшин И.Ю. О формировании множеств прецедентов на основе таблиц разнородных признаковых описаний методами топологической теории анализа данных. Информатика и ее применения. 2023; 17 (3): 2–7. https://doi.org/10.14357/19922264230301.Torshin I.Yu. On the formation of sets of precedents based on tables of heterogeneous feature descriptions by methods of topological theory of data analysis. Informatics and Applications. 2023; 17 (3): 2–7 (in Russ.). https://doi.org/10.14357/19922264230301.Frydman A.M., Le Roux Y., Desnottes J.F., et al. Pharmacokinetics of spiramycin in man. J Antimicrob Chemother. 1988; 22 (Suppl B): 93–103. https://doi.org/10.14357/199222642302011093/jac/22.supplement_b.93.Frydman A.M., Le Roux Y., Desnottes J.F., et al. Pharmacokinetics of spiramycin in man. J Antimicrob Chemother. 1988; 22 (Suppl B): 93–103. https://doi.org/10.14357/199222642302011093/jac/22.supplement_b.93.Smith C.R. The spiramycin paradox. J Antimicrob Chemother. 1988; 22 (Suppl B): 141–4. https://doi.org/10.1093/jac/22.supplement_b.141.Smith C.R. The spiramycin paradox. J Antimicrob Chemother. 1988; 22 (Suppl B): 141–4. https://doi.org/10.1093/jac/22.supplement_b.141.Яковлев С.В., Суворова М.П. Ренессанс спирамицина в клинической практике. Антибиотики и химиотерапия. 2023; 68 (7–8): 83–9. https://doi.org/10.37489/0235-2990-2023-68-7-8-83-89.Yakovlev S.V., Suvorova М.Р. The renaissance of spiramycin in clinical practice. Antibiotiki i khimioterapiya / Antibiotics and Chemotherapy. 2023; 68 (7–8): 83–9. (In Russ.) https://doi.org/10.37489/0235-2990-2023-68-7-8-83-89.Franco P.S., Gomes A.O., Barbosa B.F., et al. Azithromycin and spiramycin induce anti-inflammatory response in human trophoblastic (BeWo) cells infected by Toxoplasma gondii but are able to control infection. Placenta. 2011; 32 (11): 838–44. https://doi.org/10.1016/j.placenta.2011.08.012.Franco P.S., Gomes A.O., Barbosa B.F., et al. Azithromycin and spiramycin induce anti-inflammatory response in human trophoblastic (BeWo) cells infected by Toxoplasma gondii but are able to control infection. Placenta. 2011; 32 (11): 838–44. https://doi.org/10.1016/j.placenta.2011.08.012.Grujić J., Djurković-Djaković O., Nikolić A., et al. Effectiveness of spiramycin in murine models of acute and chronic toxoplasmosis. Int J Antimicrob Agents. 2005; 25 (3): 226–30. https://doi.org/10.1016/j.ijantimicag.2004.09.015.Grujić J., Djurković-Djaković O., Nikolić A., et al. Effectiveness of spiramycin in murine models of acute and chronic toxoplasmosis. Int J Antimicrob Agents. 2005; 25 (3): 226–30. https://doi.org/10.1016/j.ijantimicag.2004.09.015.Chew W.K., Segarra I., Ambu S., Mak J.W. Significant reduction of brain cysts caused by Toxoplasma gondii after treatment with spiramycin coadministered with metronidazole in a mouse model of chronic toxoplasmosis. Antimicrob Agents Chemother. 2012; 56 (4): 1762–8. https://doi.org/10.1128/AAC.05183-11.Chew W.K., Segarra I., Ambu S., Mak J.W. Significant reduction of brain cysts caused by Toxoplasma gondii after treatment with spiramycin coadministered with metronidazole in a mouse model of chronic toxoplasmosis. Antimicrob Agents Chemother. 2012; 56 (4): 1762–8. https://doi.org/10.1128/AAC.05183-11.El Saftawy E.A., Turkistani S.A., Alghabban H.M., et al. Effects of Lactobacilli acidophilus and/or spiramycin as an adjunct in toxoplasmosis infection challenged with diabetes. Food Waterborne Parasitol. 2023; 32: e00201. https://doi.org/10.1016/j.fawpar.2023.e00201.El Saftawy E.A., Turkistani S.A., Alghabban H.M., et al. Effects of Lactobacilli acidophilus and/or spiramycin as an adjunct in toxoplasmosis infection challenged with diabetes. Food Waterborne Parasitol. 2023; 32: e00201. https://doi.org/10.1016/j.fawpar.2023.e00201.Berrébi A., Assouline C., Bessières M.H., et al. Long-term outcome of children with congenital toxoplasmosis. Am J Obstet Gynecol. 2010; 203 (6): 552.e1–6. https://doi.org/10.1016/j.ajog.2010.06.002.Berrébi A., Assouline C., Bessières M.H., et al. Long-term outcome of children with congenital toxoplasmosis. Am J Obstet Gynecol. 2010; 203 (6): 552.e1–6. https://doi.org/10.1016/j.ajog.2010.06.002.Cetinkaya Demir B., Yuruk O., Heper Y., Ozkan H. Toxoplasmosis in pregnancy; analysis of maternal seropositivity in a large cohort in Turkey and clinical consequences of neonates. Medicine. 2025; 104 (40): e44881. https://doi.org/10.1097/MD.0000000000044881.Cetinkaya Demir B., Yuruk O., Heper Y., Ozkan H. Toxoplasmosis in pregnancy; analysis of maternal seropositivity in a large cohort in Turkey and clinical consequences of neonates. Medicine. 2025; 104 (40): e44881. https://doi.org/10.1097/MD.0000000000044881.De Santis M., Tartaglia S., Apicella M., et al. The prevention of congenital toxoplasmosis using a combination of Spiramycin and Cotrimoxazole: the long-time experience of a tertiary referral centre. Trop Med Int Health. 2024; 29 (8): 697–705. https://doi.org/10.1111/tmi.14021.De Santis M., Tartaglia S., Apicella M., et al. The prevention of congenital toxoplasmosis using a combination of Spiramycin and Cotrimoxazole: the long-time experience of a tertiary referral centre. Trop Med Int Health. 2024; 29 (8): 697–705. https://doi.org/10.1111/tmi.14021.Ribeiro S.K., Mariano I.M., Cunha A.C.R., et al. Treatment protocols for gestational and congenital toxoplasmosis: a systematic review and meta-analysis. Microorganisms. 2025; 13 (4): 723. https://doi.org/10.3390/microorganisms13040723.Ribeiro S.K., Mariano I.M., Cunha A.C.R., et al. Treatment protocols for gestational and congenital toxoplasmosis: a systematic review and meta-analysis. Microorganisms. 2025; 13 (4): 723. https://doi.org/10.3390/microorganisms13040723.Montoya J.G., Laessig K., Fazeli M.S., et al. A fresh look at the role of spiramycin in preventing a neglected disease: meta-analyses of observational studies. Eur J Med Res. 2021; 26 (1): 143. https://doi.org/10.1186/s40001-021-00606-7.Montoya J.G., Laessig K., Fazeli M.S., et al. A fresh look at the role of spiramycin in preventing a neglected disease: meta-analyses of observational studies. Eur J Med Res. 2021; 26 (1): 143. https://doi.org/10.1186/s40001-021-00606-7.Hotop A., Hlobil H., Gross U. Efficacy of rapid treatment initiation following primary Toxoplasma gondii infection during pregnancy. Clin Infect Dis. 2012; 54 (11): 1545–52. https://doi.org/10.1093/cid/cis234.Hotop A., Hlobil H., Gross U. Efficacy of rapid treatment initiation following primary Toxoplasma gondii infection during pregnancy. Clin Infect Dis. 2012; 54 (11): 1545–52. https://doi.org/10.1093/cid/cis234.Thiébaut R., Leproust S., Chêne G., Gilbert R. Effectiveness of prenatal treatment for congenital toxoplasmosis: a meta-analysis of individual patients' data. Lancet. 2007; 369 (9556): 115–22. https://doi.org/10.1016/S0140-6736(07)60072-5.Thiébaut R., Leproust S., Chêne G., Gilbert R. Effectiveness of prenatal treatment for congenital toxoplasmosis: a meta-analysis of individual patients' data. Lancet. 2007; 369 (9556): 115–22. https://doi.org/10.1016/S0140-6736(07)60072-5.Masata J., Rezácová J., Sodja I. Treatment of chlamydial urogenital infections. Ceska Gynekol. 1998; 63 (4): 279–82 (in Czech).Masata J., Rezácová J., Sodja I. Treatment of chlamydial urogenital infections. Ceska Gynekol. 1998; 63 (4): 279–82 (in Czech).Orfila J., Haider F., Thomas D. Activity of spiramycin against chlamydia, in vitro and in vivo. J Antimicrob Chemother. 1988; 22 (Suppl. B): 73–6. https://doi.org/10.1093/jac/22.supplement_b.73.Orfila J., Haider F., Thomas D. Activity of spiramycin against chlamydia, in vitro and in vivo. J Antimicrob Chemother. 1988; 22 (Suppl. B): 73–6. https://doi.org/10.1093/jac/22.supplement_b.73.Segev S., Samra Z., Eliav E., et al. The efficacy and safety of spiramycin in the treatment of nongonococcal urethritis in men. J Antimicrob Chemother. 1988; 22 (Suppl. B): 183–7. https://doi.org/10.1093/jac/22.supplement_b.183.Segev S., Samra Z., Eliav E., et al. The efficacy and safety of spiramycin in the treatment of nongonococcal urethritis in men. J Antimicrob Chemother. 1988; 22 (Suppl. B): 183–7. https://doi.org/10.1093/jac/22.supplement_b.183.Chiappe V., Gómez M., Fernández-Canigia L., Romanelli H. The effect of spiramycin on Porphyromonas gingivalis and other “classic” periopathogens. Acta Odontol Latinoam. 2011; 24 (1): 115–21.Chiappe V., Gómez M., Fernández-Canigia L., Romanelli H. The effect of spiramycin on Porphyromonas gingivalis and other “classic” periopathogens. Acta Odontol Latinoam. 2011; 24 (1): 115–21.Ravishankar P.L., Venugopal K., Nadkerny P. Effect of tetracycline hydrochloride and spiramycin sub gingival irrigation with pulsated jet irrigator in chronic periodontitis patients: a clinical study. J Int Oral Health. 2015; 7 (7): 102–7.Ravishankar P.L., Venugopal K., Nadkerny P. Effect of tetracycline hydrochloride and spiramycin sub gingival irrigation with pulsated jet irrigator in chronic periodontitis patients: a clinical study. J Int Oral Health. 2015; 7 (7): 102–7.Lakhssassi N., Sixou M. Efficacy variation of erythromycin and spiramycin on periopathogens in aggressive periodontitis. An in vitro comparative study. Pathol Biol. 2005; 53 (8–9): 527–35 (in French). https://doi.org/10.1016/j.patbio.2005.06.008.Lakhssassi N., Sixou M. Efficacy variation of erythromycin and spiramycin on periopathogens in aggressive periodontitis. An in vitro comparative study. Pathol Biol. 2005; 53 (8–9): 527–35 (in French). https://doi.org/10.1016/j.patbio.2005.06.008.Rams T.E., Dujardin S., Sautter J.D., et al. Spiramycin resistance in human periodontitis microbiota. Anaerobe. 2011; 17 (4): 201–5. https://doi.org/10.1016/j.anaerobe.2011.03.017.Rams T.E., Dujardin S., Sautter J.D., et al. Spiramycin resistance in human periodontitis microbiota. Anaerobe. 2011; 17 (4): 201–5. https://doi.org/10.1016/j.anaerobe.2011.03.017.Roche Y., Yoshimori R.N. In-vitro activity of spiramycin and metronidazole alone or in combination against clinical isolates from odontogenic abscesses. J Antimicrob Chemother. 1997; 40 (3): 353–7. https://doi.org/10.1093/jac/40.3.353.Roche Y., Yoshimori R.N. In-vitro activity of spiramycin and metronidazole alone or in combination against clinical isolates from odontogenic abscesses. J Antimicrob Chemother. 1997; 40 (3): 353–7. https://doi.org/10.1093/jac/40.3.353.Bergogne-Bérézin E. Spiramycin concentrations in the human respiratory tract: a review. J Antimicrob Chemother. 1988; 22 (Suppl. B): 117–22. https://doi.org/10.1093/jac/22.supplement_b.117.Bergogne-Bérézin E. Spiramycin concentrations in the human respiratory tract: a review. J Antimicrob Chemother. 1988; 22 (Suppl. B): 117–22. https://doi.org/10.1093/jac/22.supplement_b.117.Kitzis M., Desnottes J.F., Brunel D., et al. Spiramycin concentrations in lung tissue. J Antimicrob Chemother. 1988; 22 (Suppl. B): 123–6. https://doi.org/10.1093/jac/22.supplement_b.123.Kitzis M., Desnottes J.F., Brunel D., et al. Spiramycin concentrations in lung tissue. J Antimicrob Chemother. 1988; 22 (Suppl. B): 123–6. https://doi.org/10.1093/jac/22.supplement_b.123.Sutherland R. Spiramycin: a reappraisal of its antibacterial activity. Br J Pharmacol Chemother. 1962; 19 (1): 99–110. https://doi.org/10.1111/j.1476-5381.1962.tb01430.x.Sutherland R. Spiramycin: a reappraisal of its antibacterial activity. Br J Pharmacol Chemother. 1962; 19 (1): 99–110. https://doi.org/10.1111/j.1476-5381.1962.tb01430.x.Rondini G., Cocuzza C.E., Cianflone M., et al. Bacteriological and clinical efficacy of various antibiotics used in the treatment of streptococcal pharyngitis in Italy. An epidemiological study. Int J Antimicrob Agents. 2001; 18 (1): 9–17. https://doi.org/10.1016/s0924-8579(01)00342-9.Rondini G., Cocuzza C.E., Cianflone M., et al. Bacteriological and clinical efficacy of various antibiotics used in the treatment of streptococcal pharyngitis in Italy. An epidemiological study. Int J Antimicrob Agents. 2001; 18 (1): 9–17. https://doi.org/10.1016/s0924-8579(01)00342-9.Jeannin L., Vergeret J., Caillaud D., et al. Community-acquired pneumonia in healthy adults: 188 patients treated with spiramycin in private practice. Rev Pneumol Clin. 1992; 48 (6): 263–8 (in French).Jeannin L., Vergeret J., Caillaud D., et al. Community-acquired pneumonia in healthy adults: 188 patients treated with spiramycin in private practice. Rev Pneumol Clin. 1992; 48 (6): 263–8 (in French).Mgbor N.C., Umeh R.E. A blind parallel comparative study of the efficacy and safety of rovamycin versus augmentin in the treatment of acute otitis media. West Afr J Med. 2002; 21 (2): 117–20.Mgbor N.C., Umeh R.E. A blind parallel comparative study of the efficacy and safety of rovamycin versus augmentin in the treatment of acute otitis media. West Afr J Med. 2002; 21 (2): 117–20.De Cock L., Poels R. Comparison of spiramycin with erythromycin for lower respiratory tract infections. J Antimicrob Chemother. 1988; 22 (Suppl. B): 159–63. https://doi.org/10.1093/jac/22.supplement_b.159.De Cock L., Poels R. Comparison of spiramycin with erythromycin for lower respiratory tract infections. J Antimicrob Chemother. 1988; 22 (Suppl. B): 159–63. https://doi.org/10.1093/jac/22.supplement_b.159.Громова О.А., Торшин И.Ю. Хемоинформационное исследование спирамицина в сравнении с другими антибиотиками. ФАРМАКОЭКОНОМИКА. Современная фармакоэкономика и фармакоэпидемиология. 2025; 18 (1): 80–94. https://doi.org/10.17749/2070-4909/farmakoekonomika.2025.296.Gromovа O.A., Torshin I.Yu. Chemoinformatic study of spiramycin in comparison with other antibiotics. FARMAKOEKONOMIKA. Sovremennaya farmakoekonomika i farmakoepidemiologiya / FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2025; 18 (1): 80–94 (in Russ.).Vazquez D. Binding to ribosomes and inhibitory effect on protein synthesis of the spiramycin antibiotics. Life Sci. 1967; 6 (8): 845–53. https://doi.org/10.1016/0024-3205(67)90287-1.Vazquez D. Binding to ribosomes and inhibitory effect on protein synthesis of the spiramycin antibiotics. Life Sci. 1967; 6 (8): 845–53. https://doi.org/10.1016/0024-3205(67)90287-1.Sáez-Llorens X., Odio C.M., Umaña M.A., Morales M.V. Spiramycin vs. placebo for treatment of acute diarrhea caused by Cryptosporidium. Pediatr Infect Dis J. 1989; 8 (3): 136–40.Sáez-Llorens X., Odio C.M., Umaña M.A., Morales M.V. Spiramycin vs. placebo for treatment of acute diarrhea caused by Cryptosporidium. Pediatr Infect Dis J. 1989; 8 (3): 136–40.Mayaud C., Dournon E., Montagne V., et al. Efficacy of intravenous spiramycin in the treatment of severe Legionnaires' disease. J Antimicrob Chemother. 1988; 22 (Suppl. B): 179–82. https://doi.org/10.1093/jac/22.supplement_b.179.Mayaud C., Dournon E., Montagne V., et al. Efficacy of intravenous spiramycin in the treatment of severe Legionnaires' disease. J Antimicrob Chemother. 1988; 22 (Suppl. B): 179–82. https://doi.org/10.1093/jac/22.supplement_b.179.Stuart J.G., Ferretti J.J. Genetic analysis of antibiotic resistance in Streptococcus pyogenes. J Bacteriol. 1978; 133 (2): 852–9. https://doi.org/10.1128/jb.133.2.852-859.1978.Stuart J.G., Ferretti J.J. Genetic analysis of antibiotic resistance in Streptococcus pyogenes. J Bacteriol. 1978; 133 (2): 852–9. https://doi.org/10.1128/jb.133.2.852-859.1978.Chabbert Y.A. Early studies on in-vitro and experimental activity of spiramycin: a review. J Antimicrob Chemother. 1988; 22 (Suppl. B): 1–11. https://doi.org/10.1093/jac/22.supplement_b.1.Chabbert Y.A. Early studies on in-vitro and experimental activity of spiramycin: a review. J Antimicrob Chemother. 1988; 22 (Suppl. B): 1–11. https://doi.org/10.1093/jac/22.supplement_b.1.Brook I. Synergy between spiramycin and metronidazole in the treatment of polymicrobial infections. J Antimicrob Chemother. 1988; 22 (Suppl. B): 77–85. https://doi.org/10.1093/jac/22.supplement_b.77.Brook I. Synergy between spiramycin and metronidazole in the treatment of polymicrobial infections. J Antimicrob Chemother. 1988; 22 (Suppl. B): 77–85. https://doi.org/10.1093/jac/22.supplement_b.77.Avci M.E., Arslan F., Çiftçi Ş., et al. Role of spiramycin in prevention of fetal toxoplasmosis. J Matern Fetal Neonatal Med. 2016; 29 (13): 2073–6. https://doi.org/10.3109/14767058.2015.1074998.Avci M.E., Arslan F., Çiftçi Ş., et al. Role of spiramycin in prevention of fetal toxoplasmosis. J Matern Fetal Neonatal Med. 2016; 29 (13): 2073–6. https://doi.org/10.3109/14767058.2015.1074998.Descotes J., Vial T., Delattre D., Evreux J.C. Spiramycin: safety in man. J Antimicrob Chemother. 1988; 22 (Suppl. B): 207–10. https://doi.org/10.1093/jac/22.supplement_b.207.Descotes J., Vial T., Delattre D., Evreux J.C. Spiramycin: safety in man. J Antimicrob Chemother. 1988; 22 (Suppl. B): 207–10. https://doi.org/10.1093/jac/22.supplement_b.207.Торшин И.Ю., Калачева А.Г., Громова О.А., Рогозин М.А. Оценка препаратов рубрикатора АТХ методом хемореактомного скрининга для профилактики дефицитов магния и пиридоксина. Фармакокинетика и фармакодинамика. 2025; 3: 21–9. https://doi.org/10.37489/2587-7836-2025-3-21-29.Torshin I.Yu., Kalacheva A.G., Gromova O.A., Rogozin M.A. Evaluation of ATX rubricator drugs by chemoreactome screening method for prevention of magnesium and pyridoxine deficiencies. Pharmacokinetics and Pharmacodynamics. 2025; 3: 21–9 (in Russ.). https://doi.org/10.37489/2587-7836-2025-3-21-29.Громова О.А., Торшин И.Ю., Лиманова О.А. и др. Антибиотикотерапия провоцирует дефицит магния. Что делать? Фарматека. 2016; 14: 6–13.Gromova O.A., Torshin I.Yu., Limanova O.A., et al. Antibiotic therapy provokes development of magnesium deficiency. What is to be done? Farmateka. 2016; 14: 6–13.Клинические рекомендации «Желудочковые аритмии у взрослых» (утв. Минздравом России), 2016. URL: https://library.mededtech.ru/rest/documents/cr_244 (дата обращения 20.11.2025).Clinical guidelines “Ventricular arrhythmias in adults” (approved by the Ministry of Health of Russia), 2016. Available at: https://library.mededtech.ru/rest/documents/cr_244 (in Russ.) (accessed 20.11.2025).Kang J.K., Kang H.K., Hyun C.G. Anti-inflammatory effects of spiramycin in LPS-activated RAW 264.7 macrophages. Molecules. 2022; 27 (10): 3202. https://doi.org/10.3390/molecules27103202.Kang J.K., Kang H.K., Hyun C.G. Anti-inflammatory effects of spiramycin in LPS-activated RAW 264.7 macrophages. Molecules. 2022; 27 (10): 3202. https://doi.org/10.3390/molecules27103202.Neuweiler W., Ritter P. Rovamycin therapy of puerperal mastitis. Geburtshilfe Frauenheilkd. 1957; 17 (5): 405–13.Neuweiler W., Ritter P. Rovamycin therapy of puerperal mastitis. Geburtshilfe Frauenheilkd. 1957; 17 (5): 405–13.Matsuda M., Goto A., Saito H., et al. Suppressive effect of spiramycin on cell division. Jpn J Antibiot. 2003; 56 (Suppl. A): 121–3 (in Japanese).Matsuda M., Goto A., Saito H., et al. Suppressive effect of spiramycin on cell division. Jpn J Antibiot. 2003; 56 (Suppl. A): 121–3 (in Japanese).Wang Z., Cheng J., Wen H., et al. Synthesis, anticancer and antibacterial evaluation of novel spiramycin-acylated derivatives. RSC Adv. 2024; 14 (52): 38898–907. https://doi.org/10.1039/d4ra03126a.Wang Z., Cheng J., Wen H., et al. Synthesis, anticancer and antibacterial evaluation of novel spiramycin-acylated derivatives. RSC Adv. 2024; 14 (52): 38898–907. https://doi.org/10.1039/d4ra03126a.Yang R., Otkur W., Feng T., et al. Uncovering anticancer mechanisms of spiramycin derivatives using transcriptomic and metabolomic analyses. Metabolites. 2025; 15 (10): 647 https://doi.org/10.3390/metabo15100647.Yang R., Otkur W., Feng T., et al. Uncovering anticancer mechanisms of spiramycin derivatives using transcriptomic and metabolomic analyses. Metabolites. 2025; 15 (10): 647 https://doi.org/10.3390/metabo15100647.Kim M.O., Ryu H.W., Choi J.H., et al. Anti-obesity effects of spiramycin in vitro and in vivo. PLoS One. 2016; 11 (7): e0158632. https://doi.org/10.1371/journal.pone.0158632.Kim M.O., Ryu H.W., Choi J.H., et al. Anti-obesity effects of spiramycin in vitro and in vivo. PLoS One. 2016; 11 (7): e0158632. https://doi.org/10.1371/journal.pone.0158632.Байгозина Е.А., Подгурская Е. П., Сенина О.А. и др. Возможности применения и клиническая эффективность спирамицина в эмпирической терапии инфекции нижних дыхательных путей в современных условиях. Русский медицинский журнал. 2024; 1: 47–51.Baigozina E.A., Podgurskaya E.P., Senina O.A., et al. Potential for use and clinical efficacy of spiramycin in the empirical treatment of lower respiratory tract infection in present day. Russian Medical Journal. 2024; 1: 47–51.Martin-Loeches I., Torres A., Nagavci В., et al. ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia. Intensive Care Med. 2023; 49 (6): 615–32. https://doi.org/10.1007/s00134-023-07033-8.Martin-Loeches I., Torres A., Nagavci В., et al. ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia. Intensive Care Med. 2023; 49 (6): 615–32. https://doi.org/10.1007/s00134-023-07033-8.Козлов Р.С., Иванчик Н.В., Микотина А.В., Дехнич А.В. In vitro активность макролидных антибиотиков в отношении Streptococcus pneumoniae и Streptococcus pyogenes в Российской Федерации: “Status praesens”. Клиническая микробиология и антимикробная химиотерапия. 2024; 26 (3): 318–26. https://doi.org/10.36488/cmac.2024.3.318-326.Kozlov R.S., Ivanchik N.V., Mikotina A.V., Dekhnich A.V. In vitro activity of macrolides against Streptococcus pneumoniae and Streptococcus pyogenes in the Russian Federation: “Status praesens”. Clinical Microbiology and Antimicrobial Chemotherapy. 2024; 26 (3): 318–26 (in Russ.). https://doi.org/10.36488/cmac.2024.3.318-326.Яковлев С.В., Сидоренко С.В., Рафальский В.В., Спичак Т.В. (ред.) Стратегия и тактика рационального применения антимикробных средств в амбулаторной практике: Евразийские клинические рекомендации. М.: Пре100 Принт; 2016: 144 с.Yakovlev S.V., Sidorenko S.V., Rafalsky V.V., Spichak T.V. (Eds.) Strategy and tactics of rational use of antimicrobial agents in outpatient practice: Eurasian clinical guidelines. Moscow: Pre100 Print; 2016: 144 pp. (in Russ.).WHO Model List of Essential Medicines – 23rd list, 2023. Available at: https://www.who.int/publications/i/item/WHO-MHP-HPSEML-2023.02 (accessed 20.11.2025).WHO Model List of Essential Medicines – 23rd list, 2023. Available at: https://www.who.int/publications/i/item/WHO-MHP-HPSEML-2023.02 (accessed 20.11.2025).

The authors declare that there are no conflicts of interest present.