Alternative to a penicillin in penicillin-sensitive patients, penicillin-resistant staphylococcal infections, alternative to a tetracycline in mycoplasma pneumonia, pertussis, diphtheriaespecially in treatment of the carrier state, rheumatic fever prophylaxis, chronic bronchitis, otitis media & chronic prostatitis.
Erythromycin inhibits microsomal protein synthesis in susceptible organisms by inhibiting the translocation process. Specific binding to the 50S subunit or 70S ribosome occurs in these organisms but there is no binding to the stable 80S mammalian ribosome. Erythromycin is active against many Grampositive bacteria, some Gram-negative bacteria and against mycoplasmas and chlamydia.
Absorption: Erythromycin base is destroyed by acid and is therefore administered in the form of stable ester. The rates of absorption of the base and esters are diminished by the presence of food. The stearate is hydrolyzed in the intestine and the free erythromycin absorbed.
Blood concentration: After an oral dose of 500 mg. of the base of stearate, peak serum concentrations of 0.9 to 1.4 or 0.4 to 1.8 mg/ml. respectively are attained in 1 to 4 hours. Half-life: The serum half-life is 1.2 to 4 hours. In subjects with oliguria, the half-life is about 5 hours.
Distribution: Erythromycin is widely distributed throughout body tissue and fluids with some retention in the liver and spleen, protein binding of erythromycin base is 73%. Erythromycin enters the cerebrospinal fluid when the meninges are inflamed. It also crosses the placenta and is excreted in the milk.
Excretion: 5 to 15 % of the dose of erythromycin is excreted in the urine and large amounts of the unchanged active substance are excreted in the bile.
Adults : 1-2 gm daily in divided doses. Children : 30-50 mg/kg/day.
Recent data from studies of erythromycin reveals that its use in patients who are receiving high dosage of theophylline may be associated with an increase of serum theophylline levels and potential theophylline toxicity. In such cases this dose of theophylline should be reduced.
Hypersensitivity to Erythromycines, impaired hepatic function.
Nausea, gastrointestinal disturbances & allergy being the commonest ( 0.5-5%) adverse Effects.
There is no evidence that the use of Erythromycin is hazardous in pregnancy though it does cross the placental barrier.
In case of overdosage, Erythromycin should be discontinued. Overdosage should be handled with the prompt elimination of unabsorbed drug and all other appropriate measures should be instituted. Erythromycin is not removed by peritoneal dialysis or haemodialysis.
Keep below 25°C temperature, away from light & moisture. Keep out of the reach of children.
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