Erythromycin: Difference between revisions

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==General==
==General==
*Type:  
*Type: [[Is DrugClass::Macrolide]]
*Dosage Forms:
*Dosage Forms: PO, IV, topical
*Common Trade Names:  
*Common Trade Names:  


==Adult Dosing==
==Adult Dosing==
*250-500mg PO q6h
===Pre-endoscopy===
*3mg/kg IV over 20-30min, 30-90min prior to endoscopy
**Achieves endoscopy conditions equal to lavage<ref>Pateron D, et al. Erythromycin infusion or gastric lavage for upper gastrointestinal bleeding: a multicenter randomized controlled trial. Ann Emerg Med. 2011; 57(6):582-589.</ref>


==Pediatric Dosing==
==Pediatric Dosing==
*Mild-moderate infections: 30-50 mg/kg/day PO divided q6-8hr 
*Severe infection: 60-100 mg/kg/day PO divided q6-8hr


==Special Populations==
==Special Populations==
*Pregnancy:
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B
*Lactation:
*[[Lactation risk categories|Lactation risk]]: AAP categorizes as compatible with breastfeeding
*Renal Dosing
*Renal Dosing: No adjustment
**Adult
*Hepatic Dosing: Use caution
**Pediatric
*Hepatic Dosing
**Adult
**Pediatric


==Contraindications==
==Contraindications==
*Allergy to class/drug
*Allergy to class/drug
* QT prolongation


==Adverse Reactions==
==Adverse Reactions==
===Serious===
===Serious===
*Torsades, ventricular dysrhythmias
*Pseudomembranous colitis
*Hypertrophic pyloric stenosis
*Seizures


===Common===
===Common===
* nausea/vomiting
* diarrhea
* urticaria
* transaminitis
* urticarial rash


==Pharmacology==
==Pharmacology==
*Half-life:  
*Half-life: 2 hours
*Metabolism:  
*Metabolism: Liver
*Excretion:  
*Excretion: Bile/Renal
*Mechanism of Action:
*Mechanism of Action: Binds to 50S ribosomal unit → inhibiting protein synthesis
 
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||I
|-
| ||[[Strep. Pneumoniae]]||I
|-
| ||[[Viridans strep]]||X1
|-
| ||Strep. anginosus gp||X1
|-
| ||[[Enterococcus faecalis]]||R
|-
| ||[[Enterococcus faecium]]||R
|-
| ||[[MSSA]]||I
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||I
|-
| ||[[Staph. Epidermidis]]||I
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||'''S'''
|-
| Gram Negatives||[[N. gonorrhoeae]]||I
|-
| ||[[N. meningitidis]]||X2
|-
| ||[[Moraxella catarrhalis]]||I
|-
| ||[[H. influenzae]]||I
|-
| ||[[E. coli]]||R
|-
| ||[[Klebsiella]] sp||R
|-
| ||E. coli/Klebsiella ESBL+||R
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||R
|-
| ||[[Enterobacter]] sp, AmpC pos||R
|-
| ||[[Serratia]] sp||X1
|-
| ||Serratia marcescens||R
|-
| ||[[Salmonella]] sp||R
|-
| ||[[Shigella]] sp||R
|-
| ||[[Proteus mirabilis]]||X1
|-
| ||[[Proteus vulgaris]]||R
|-
| ||[[Providencia sp.]]||X1
|-
| ||[[Morganella sp.]]||X1
|-
| ||[[Citrobacter freundii]]||X1
|-
| ||[[Citrobacter diversus]]||X1
|-
| ||[[Citrobacter sp.]]||X1
|-
| ||[[Aeromonas sp]]||X1
|-
| ||[[Acinetobacter sp.]]||R
|-
| ||[[Pseudomonas aeruginosa]]||R
|-
| ||[[Burkholderia cepacia]]||R
|-
| ||[[Stenotrophomonas maltophilia]]||R
|-
| ||[[Yersinia enterocolitica]]||R
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||R
|-
| ||[[Legionella sp.]]||'''S'''
|-
| ||[[Pasteurella multocida]]||X1
|-
| ||[[Haemophilus ducreyi]]||'''S'''
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||'''S'''
|-
| ||[[Mycoplasm pneumoniae]]||'''S'''
|-
| ||[[Rickettsia sp]]||I
|-
| ||[[Mycobacterium avium]]||X1
|-
| Anaerobes||[[Actinomyces]]||'''S'''
|-
| ||[[Bacteroides fragilis]]||R
|-
| ||[[Prevotella melaninogenica]]||X1
|-
| ||[[Clostridium difficile]]||X1
|-
| ||[[Clostridium (not difficile)]]||I
|-
| ||[[Fusobacterium necrophorum]]||R
|-
| ||[[Peptostreptococcus sp.]]||I
|}
 
===Key===
{{Template:Antibacterial Spectra Key}}


==See Also==
==See Also==
*[[Antibiotics (Main)]]
*[[Antibiotics (Main)]]


==Source==
==References==
 
<references/>
<references/>
[[Category:Drugs]]
[[Category:Pharmacology]]
[[Category:ID]]

Latest revision as of 16:34, 18 July 2025

General

  • Type: Macrolide
  • Dosage Forms: PO, IV, topical
  • Common Trade Names:

Adult Dosing

  • 250-500mg PO q6h

Pre-endoscopy

  • 3mg/kg IV over 20-30min, 30-90min prior to endoscopy
    • Achieves endoscopy conditions equal to lavage[1]

Pediatric Dosing

  • Mild-moderate infections: 30-50 mg/kg/day PO divided q6-8hr
  • Severe infection: 60-100 mg/kg/day PO divided q6-8hr

Special Populations

Contraindications

  • Allergy to class/drug
  • QT prolongation

Adverse Reactions

Serious

  • Torsades, ventricular dysrhythmias
  • Pseudomembranous colitis
  • Hypertrophic pyloric stenosis
  • Seizures

Common

  • nausea/vomiting
  • diarrhea
  • urticaria
  • transaminitis
  • urticarial rash

Pharmacology

  • Half-life: 2 hours
  • Metabolism: Liver
  • Excretion: Bile/Renal
  • Mechanism of Action: Binds to 50S ribosomal unit → inhibiting protein synthesis

Antibiotic Sensitivities[2]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G I
Strep. Pneumoniae I
Viridans strep X1
Strep. anginosus gp X1
Enterococcus faecalis R
Enterococcus faecium R
MSSA I
MRSA R
CA-MRSA I
Staph. Epidermidis I
C. jeikeium R
L. monocytogenes S
Gram Negatives N. gonorrhoeae I
N. meningitidis X2
Moraxella catarrhalis I
H. influenzae I
E. coli R
Klebsiella sp R
E. coli/Klebsiella ESBL+ R
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg R
Enterobacter sp, AmpC pos R
Serratia sp X1
Serratia marcescens R
Salmonella sp R
Shigella sp R
Proteus mirabilis X1
Proteus vulgaris R
Providencia sp. X1
Morganella sp. X1
Citrobacter freundii X1
Citrobacter diversus X1
Citrobacter sp. X1
Aeromonas sp X1
Acinetobacter sp. R
Pseudomonas aeruginosa R
Burkholderia cepacia R
Stenotrophomonas maltophilia R
Yersinia enterocolitica R
Francisella tularensis X1
Brucella sp. R
Legionella sp. S
Pasteurella multocida X1
Haemophilus ducreyi S
Vibrio vulnificus X1
Misc Chlamydophila sp S
Mycoplasm pneumoniae S
Rickettsia sp I
Mycobacterium avium X1
Anaerobes Actinomyces S
Bacteroides fragilis R
Prevotella melaninogenica X1
Clostridium difficile X1
Clostridium (not difficile) I
Fusobacterium necrophorum R
Peptostreptococcus sp. I

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References

  1. ↑ Pateron D, et al. Erythromycin infusion or gastric lavage for upper gastrointestinal bleeding: a multicenter randomized controlled trial. Ann Emerg Med. 2011; 57(6):582-589.
  2. ↑ Sanford Guide to Antimicrobial Therapy 2014
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