III. Mechanism

  1. See Macrolide

IV. Adverse Effects

  1. Gastrointestinal upset
  2. Nausea
  3. Cholestatic Jaundice
  4. Multiple Drug Interactions
  5. Candida Vaginitis infection
  6. Gram Negative Folliculitis
  7. Myasthenia Gravis exacerbation
  8. Hypertrophic Pyloric Stenosis (age <45 days)
  9. QT Prolongation
    1. Class effect with Macrolides
    2. Three fold increased risk of Sudden Cardiac Death while on Azithromycin
    3. Higher risk with known QTc Prolongation, Hypokalemia, Hypomagnesemia, Class IA or III Antiarrhythmics
    4. Ray (2013) N Engl J Med 366(20): 1881-90 [PubMed]

V. Drug Interactions

  1. See Macrolide
  2. Strong CYP3A4 Inhibitor
    1. Numerous Drug Interactions
  3. Warfarin
    1. May increase INR

VI. Pharmacokinetics

  1. Half life: 1.5 hours

VII. Dosing

  1. See Erythromycin Ethyl Succinate (EES)
  2. See Erythromycin Lactobionate
  3. See Pertussis
  4. Erythromycin Oral Preparations (Take with food to reduce GI Upset)
    1. Erythromycin Base
      1. Adult: Take 250 to 500 mg orally four times daily OR 333 mg orally three times daily
      2. Child: Take 30 to 50 mg/kg/day divided four times daily
    2. Erythromycin Ethyl Succinate (EES)
      1. Adult: 400 mg orally four times daily
      2. Child: 30-50 mg/kg/day divided orally four times daily
  5. Erythromycin Parenteral Preparation: Erythromycin Lactobionate
    1. Dose: 15 to 20 mg/kg/day IV divided every 6 hours
    2. Maximum: 4 grams

VIII. Safety

  1. Pregnancy Category B
  2. Considered safe in Lactation

IX. Adverse Effects

  1. Myasthenia Gravis exacerbation
  2. Hypertrophic Pyloric Stenosis (age <45 days)
  3. Strong CYP3A4 Inhibitor
    1. Numerous Drug Interactions
    2. Serious interactions resulting in death have occurred
  4. Warfarin
    1. May increase INR
  5. QT Prolongation
    1. Class effect with Macrolides
    2. Three fold increased risk of Sudden Cardiac Death while on Azithromycin
    3. Higher risk with known QTc Prolongation, Hypokalemia, Hypomagnesemia, Class IA or III Antiarrhythmics
    4. Ray (2013) N Engl J Med 366(20): 1881-90 [PubMed]

Images: Related links to external sites (from Bing)

Related Studies

Cost: Medications

erythromycin (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
ERYTHROMYCIN 0.5% EYE OINTMENT Generic $2.63 per gram
ERYTHROMYCIN 2% GEL Generic $0.75 per gram
ERYTHROMYCIN 2% SOLUTION Generic $0.41 per ml
ERYTHROMYCIN 200 MG/5 ML SUSP Generic $1.65 per ml
ERYTHROMYCIN 250 MG TABLET Generic $4.75 each
ERYTHROMYCIN 400 MG/5 ML SUSP Generic $2.55 per ml
ERYTHROMYCIN 500 MG TABLET Generic $8.25 each
ERYTHROMYCIN DR 250 MG TABLET Generic $4.53 each
ERYTHROMYCIN DR 500 MG TABLET Generic $4.85 each
ERYTHROMYCIN-BENZOYL GEL Generic $1.70 per gram

Ontology: Erythromycin (C0014806)

Definition (CHV) a kind of antibiotics
Definition (CHV) a kind of antibiotics
Definition (NCI) A broad-spectrum, macrolide antibiotic with antibacterial activity. Erythromycin diffuses through the bacterial cell membrane and reversibly binds to the 50S subunit of the bacterial ribosome. This prevents bacterial protein synthesis. Erythromycin may be bacteriostatic or bactericidal in action, depending on the concentration of the drug at the site of infection and the susceptibility of the organism involved.
Definition (MSH) A bacteriostatic antibiotic macrolide produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins.
Definition (CSP) bacteriostatic antibiotic macrolide produced by Streptomyces erythreus; in sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits; this binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins.
Definition (PDQ) A broad-spectrum, topical macrolide antibiotic with antibacterial activity. Erythromycin diffuses through the bacterial cell membrane and reversibly binds to the 50S subunit of the bacterial ribosome. This prevents bacterial protein synthesis. Erythromycin may be bacteriostatic or bactericidal in action, depending on the concentration of the drug at the site of infection and the susceptibility of the organism involved. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39234&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39234&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C476" NCI Thesaurus)
Concepts Antibiotic (T195) , Organic Chemical (T109)
MSH D004917
SnomedCT 332341008, 30427009, 372694001
LNC LP15115-6, MTHU003043
English Erythromycin, Erythromycin A, Erythromycin [skin], erythromycin, ERYTHROMYCIN, erythromycin (medication), Erythromycin Base, Erythromycin [Chemical/Ingredient], erythromycins, erythromycin base, Erythromycin [skin] (product), Erythromycin product, Erythromycin (product), Erythromycin (substance), Erythromycin, NOS, Erythromycin [skin] (substance), Erythromycin base, Erythromycins
Swedish Erytromycin
Czech erythromycin
Finnish Erytromysiini
Italian Eritromicina A, Eritromicina
Russian ERITROMITSIN, ЭРИТРОМИЦИН
Japanese エリスロシン(Erythromycin), エリスリット, タカスノン, エリスロマイシン, アイロタイシン
Croatian ERITROMICIN
Polish Erytromycyna
Spanish eritromicina (uso dermatológico) (producto), eritromicina (uso dermatológico), eritromicina (piel) (producto), eritromicina (piel), eritromicina (producto), eritromicina (sustancia), eritromicina, Eritromicina
French Érythromycine
German Erythromycin
Portuguese Eritromicina