II. Mechanism of action
- Reversibly binds 50S ribosomal subunit
- Inhibits protein synthesis
III. Bacterial resistance mechanisms
- Impermeability of Bacterial outer membranes
- Especially Gram Negative Organisms
- Production of enzymes that alter ribosomal targets
IV. Adverse Effects
- Gastrointestinal upset
- Nausea
- Cholestatic Jaundice
- Multiple Drug Interactions
V. Complications
- Candida Vaginitis infection
- Gram Negative Folliculitis
VI. Pharmacokinetics
- Half life: 1.5 hours
VII. Drug Interactions
- Interactions may also occur with extended spectrum
- Clarithromycin
- Telithromycin
- Less likely to occur with Azithromycin
-
QT Prolongation (Erythromycin with an agent below)
- Calcium Channel Blockers increase Erythromycin level
- Other potent CYP3A4 inhibitors
- References
VIII. Oral Preparations (Take with food to reduce GI Upset)
- Erythromycin base 1000 mg/day PO divided bid-qid
- Erythromycin ethyl succinate (EES)
- Adult: 400 mg PO qid
- Child: 30-50 mg/kg/day PO divided qid
IX. Parenteral Preparation: Erythromycin lactobionate
- Dose: 15 to 20 mg/kg/day IV divided every 6 hours
- Maximum: 4 grams
X. Activity Spectrum
- Major indications for Erythromycin
- Other organisms covered
- Ureaplasma urealyticum
- Treponema pallidum (Syphilis)
- Staphylococcus
- Streptococcus
- Bacillus anthracis
- Clostridium species
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| Erythromycin op. ointment ( (on 6/18/2017 at Walmart.com) | ||
| Erythromycin op. ointment (3.5gm) | #1 tube for $4.00 | $4.00 each |
| Erythromycin op. ointment (3.5gm) | #3 tubes for $10.00 | $3.33 each |
| erythromycin (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| ERYTHROMYCIN 0.5% EYE OINTMENT | Generic | $2.21 per gram |
| ERYTHROMYCIN 2% GEL | Generic | $3.08 per gram |
| ERYTHROMYCIN 2% PLEDGETS | Generic | $0.86 each |
| ERYTHROMYCIN 2% SOLUTION | Generic | $0.59 per ml |
| ERYTHROMYCIN 250 MG FILMTAB | Generic | $10.14 each |
| ERYTHROMYCIN 500 MG FILMTAB | Generic | $13.91 each |
| ERYTHROMYCIN DR 250 MG CAP | Generic | $4.45 each |
| ERYTHROMYCIN EC 250 MG CAP | Generic | $4.45 each |
| ERYTHROMYCIN ES 400 MG TAB | Generic | $9.77 each |
| ERYTHROMYCIN-BENZOYL GEL | Generic | $5.66 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 |
Ontology: Macrolides (C0282563)
| Definition (MSH) | A group of often glycosylated macrocyclic compounds formed by chain extension of multiple PROPIONATES cyclized into a large (typically 12, 14, or 16)-membered lactone. Macrolides belong to the POLYKETIDES class of natural products, and many members exhibit ANTIBIOTIC properties. |
| Definition (NCI) | A term used to describe a chemical structure of a compound containing a large lactone ring, usually with a 14 or 16-membered ring structure. The prototypical compounds within the macrolide class are the erythromycin-based antibiotics; however, many compounds with this chemical structure are being developed for other diseases. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D018942 |
| SnomedCT | 428787002 |
| English | Macrolides, Macrolide (substance), Macrolide, Macrolides [Chemical/Ingredient], macrolides, macrolide |
| Swedish | Makrolider |
| Czech | makrolidy |
| Finnish | Makrolidit |
| Russian | MAKROLIDY, МАКРОЛИДЫ |
| Spanish | macrólido, macrólido (sustancia), Macrólidos |
| Japanese | マクロライド |
| Polish | Makrolidy |
| Croatian | MAKROLIDI |
| Norwegian | Not Translated[Macrolides] |
| French | Macrolides |
| German | Makrolide |
| Italian | Macrolidi |
| Portuguese | Macrolídeos |
