The reason for worldwide increasing resistance to CLR is the high use of macrolides in treatment (Kamboj et al
[16] [18] These metabolites, including cyclic 3-hydroxymelatonin, N1-acetyl-N2-formyl-5-methoxykynuramine (AFMK), and N1-acetyl-5-methoxykynuramine (AMK), contribute to the broader antioxidative effects of melatonin through further redox reactions with free radicals
This approach is particularly advantageous against bacteria naturally producing and accumulating endogenous photosensitizers such as porphyrins and flavins (Plavskii et al., 2018), physiologically involved in several essential biological functions (e.g., respiration, biological oxidation, photosynthesis, sulfate reduction, metabolism of fats, carbohydrates, and proteins) (Shu et al., 2013
doi:10.4103/0973-1296.182175
beneficial)