Composition
Drop: Per 2.5 ml: Erythromycin ethyl succinate equiv to 100 mg erythromycin; Tab 100 mg/250 mg/500 mg: Erythromycin stearate equiv to 100 mg/250 mg/500 mg erythromycin. Tab 400 mg: Erythromyc
Indications & Dosage
Susceptible infections in patients with penicillin hypersensitivity e.g. respiratory-tract infections (including Legionella infection), skin and oral infections, and campylobacter enteritis: ORAL: Adult & Children above 8 yrs: 250-500 mg 4 times a day or total daily dose in two divided doses, increased to 500-1000 mg 4 times a day in severe infections. Children 1 month-1 yr: 125 mg 4 times a day, or total daily dose in two divided doses, increased to 250 mg 4 times a day in severe infections; 2-7 years: 250 mg 4 times a day, or total daily dose in two divided doses, increased to 500 mg 4 times a day in severe infections. BY IV INF: Adult: 6.25 mg/kg every 6 hours, for mild infections when oral treatment not possible, increased to 12.5 mg/kg every 6 hours in severe infections. Children: 12.5 mg/kg every 6 hours (max. per dose 1 g). Lyme disease (under expert supervision): ORAL: Adult: 500 mg 4 times a day for 14-21 days. Early syphilis: ORAL: Adult: 500 mg 4 times a day for 14 days. Uncomplicated genital chlamydia, Non-gonococcal urethritis: ORAL: Adult: 500 mg twice daily for 14 days. Chronic prostatitis: ORAL: Adult: 250-500 mg 4 times a day or total daily dose in two divided doses, increased to 500-1000 mg 4 times a day in severe infections. BY IV INF: Adult: 6.25 mg/kg every 6 hours, for mild infections when oral treatment is not possible, increased to 12.5 mg/kg every 6 hours in severe infections. Prevention and treatment of pertussis: ORAL: Adult & Children above 8 yrs: 250-500 mg 4 times a day or total daily dose in two divided doses, increased to 500-1000 mg 4 times a day in severe infections. Children 1 month-1 year: 125 mg 4 times a day, or total daily dose in two divided doses, increased to 250 mg 4 times a day in severe infections; 2-7 years: 250 mg 4 times a day, or total daily dose in two divided doses, increased to 500 mg 4 times a day in severe infections. Prevention of secondary case of diphtheria in non-immune patient: ORAL: Adult & Children above 8 yrs: 500 mg every 6 hours for 7 days, treat for further 10 days if nasopharyngeal swabs positive after first 7 days treatment. Children 1 month-1 yr: 125 mg every 6 hours for 7 days, treat for further 10 days if nasopharyngeal swabs positive after first 7 days' treatment; 2-7 years: 250 mg every 6 hours for 7 days, treat for further 10 days if nasopharyngeal swabs positive after first 7 days treatment. Prevention of secondary case of invasive group Astreptococcal infection in penicillin allergic patients: ORAL: Adult & Children above 8 yrs: 500 mg every 6 hours for 10 days; Children 1 month-1 year: 125 mg every 6 hours for 10 days; 2-7 years: 250 mg every 6 hours for 10 days. Prevention of recurrence of rheumatic fever: Oral: Children 1 month-1 yr: 125 mg twice daily; 2-17 years: 250 mg twice daily. Rosacea, Acne: Adult: 500 mg twice daily courses usually last 6-12 weeks and are repeated intermittently.
Administration
IV Infusion may be very irritating to the vein. If phlebitis/pain occurs with used dilution, consider diluting further (e.g. 1:5) if fluid states of the patient will tolerate, or consider administering in larger available vein, reconstitute with SWFI without preservatives to avoid gel formation. The reconstituted solution is stable for a week when refrigerated or for 24 hours at room temperature. IV form has the longest stability in 0.9% sodium chloride (NS) and should be prepared in this base solution whenever possible. Do not use D5W as a diluent unless sodium bicarbonate is added to solution. If IV must be prepared in D5W, 0.5 ml of the 8.4% sodium bicarbonate solution should be added per each 100 ml of D5W. Standard diluent: 500 mg/250 ml D5W/NS; 750 mg/250 ml D5W/NS; 1 gm/250 ml D5W/NS.
Compatibility
Stable in NS. Incompatible with D5LR, D1OW. Y-site administration: Incompatible with fluconazole.
Stability
The reconstituted solution is stable for 2 weeks when refrigerated or for 24 hours at room temperature. Stability of parenteral admixture at room temperature (25C) and at refrigeration temperature (4C) is 24 hours.
Contraindications
Porphyria.
Precautions
Predisposition to prolonged QT interval, hepatic impairment; may cause idiosyncratic hepatotoxicity. Renal impairment; max dose 1.5 g daily in adult in severe renal impairment (risk of ototoxicity), myasthenia gravis
Interactions
Amisulpride, tolterodine, astemizole, mizolastine, ergot derivatives, theophylline, carbamazepine, oral anticoagulants, digoxin, cisapride, alfentanil, bromocriptine, cyclosporin, disopyramide, amiodarone, hexobarbitone, midazolam, phenytoin, triazolam, valproate, statins, zopiclone, tacrolimus, pimozide, quinidine, rifabutin.
Pregnancy
Caution advised
Lactation
Caution advised
Side Effects
Abdominal discomfort, diarrhoea, nausea, vomiting, Cholestatic jaundice, hepatotoxicity, rash, anorexia, arthralgia, disturbances in taste and vision, dizziness, dyspepsia, flatulence, headache, malaise, paraesthesia, anxiety, chest pain, constipation, gastritis, hypoaesthesia, leucopenia, oedema, photo sensitivity, sleep disturbances, acute renal failure, convulsions, haemolytic anaemia, interstitial nephritis, syncope, thrombocytopenia, tongue discoloration. Rare: Agitation, antibiotic-associated colitis, arrhythmias, pancreatitis, QT interval prolongation, Stevens-Johnson syndrome, toxic epidermal necrolysis. With intravenous use; Local tenderness and phlebitis