The article provides an overview of current publications on the chemical structure, mechanism of action and safety of macrolide antibiotics. We conducted a search in PubMed and Google Scholar databases for the scientific articles published from 2010 to 2021. The following key words were used: macrolides, macrolide antibiotics, erythromycin, clarithromycin, azithromycin, mechanism of action, adverse drug reactions, toxicity. Macrolides are broad-spectrum antibiotics used to treat a wide range of both local and systemic infectious diseases. Macrolides are generally safe, although they can induce certain dose-dependent adverse drug reactions.