Midecamycin (Acetate) is a macrolide antibiotic with actions and uses similar to those of erythromycin but somewhat less active. It is synthesized from Streptomyces mycarofaciens. It has been given by mouth to treat variety of bacterial infections like respiratory tract, ear, skin infections etc. Antibiotics require constant drug level in body for therapeutic effect. This is achieved by taking the drug at regular interval of time throughout the day and night as prescribed. Midecamycin (Acetate) is primarily indicated in conditions like Bronchitis, Laryngopharyngitis, Otitis media, Periodontitis, Pneumonia, Respiratory tract infections, Skin infections, Subcutaneous abscess, Tonsillitis. Midecamycin inhibits bacterial growth by targeting the 50S ribosomal subunit preventing peptide bond formation and translocation during protein synthesis. Resistance to midecamycin is commonly attributed to mutations in 50S rRNA preventing midecamycin binding allowing the cell to synthesize proteins free of error.