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What is Eryped (erythromycin ethylsuccinate)?
- Upper respiratory tract infections of mild to moderate degree caused by Streptococcus pyogenes, Streptococcus pneumoniae, or Haemophilus influenzae (when used concomitantly with adequate doses of sulfonamides, since many strains of H. influenzae are not susceptible to the erythromycin concentrations ordinarily achieved). (See appropriate sulfonamide labeling for prescribing information.)
- Lower-respiratory tract infections of mild to moderate severity caused by Streptococcus pneumoniae or Streptococcus pyogenes.
- Listeriosis caused by Listeria monocytogenes.
- Pertussis (whooping cough) caused by Bordetella pertussis. Erythromycin is effective in eliminating the organism from the nasopharynx of infected individuals rendering them noninfectious. Some clinical studies suggest that erythromycin may be helpful in the prophylaxis of pertussis in exposed susceptible individuals.
- Respiratory tract infections due to Mycoplasma pneumoniae.
- Skin and skin structure infections of mild to moderate severity caused by Streptococcus pyogenes or Staphylococcus aureus (resistant staphylococci may emerge during treatment).
- Diphtheria: Infections due to Corynebacterium diphtheriae , as an adjunct to antitoxin, to prevent establishment of carriers and to eradicate the organism in carriers.
- Erythrasma: In the treatment of infections due to Corynebacterium minutissimum.
- Intestinal amebiasis caused by Entamoeba histolytica (oral erythromycins only). Extraenteric amebiasis requires treatment with other agents.
- Acute pelvic inflammatory disease caused by Neisseria gonorrhoeae: As an alternative drug in treatment of acute pelvic inflammatory disease caused by N. gonorrhoeae in female patients with a history of sensitivity to penicillin. Patients should have a serologic test for syphilis before receiving erythromycin as treatment of gonorrhea and a follow-up serologic test for syphilis after 3 months.
- Syphilis caused by Treponema pallidum: Erythromycin is an alternate choice of treatment for primary syphilis in patients allergic to the penicillins. In treatment of primary syphilis, spinal fluid examinations should be done before treatment and as part of follow-up after therapy.
- Erythromycins are indicated for the treatment of the following infections caused by Chlamydia trachomatis:
- When tetracyclines are contraindicated or not tolerated, erythromycin is indicated for the treatment of nongonococcal urethritis caused by Ureaplasma urealyticum.
- Legionnaires' Disease caused by Legionella pneumophila.
- Although no controlled clinical efficacy studies have been conducted, in vitro and limited preliminary clinical data suggest that erythromycin may be effective in treating Legionnaires' Disease.
Prevention of Initial Attacks of Rheumatic Fever
Penicillin is considered by the American Heart Association to be the drug of choice in the prevention of initial attacks of rheumatic fever (treatment of Streptococcus pyogenes infections of the upper respiratory tract, e.g., tonsillitis or pharyngitis). Erythromycin is indicated for the treatment of penicillin-allergic patients.3 The therapeutic dose should be administered for 10 days.
Prevention of Recurrent Attacks of Rheumatic Fever
Penicillin or sulfonamides are considered by the American Heart Association to be the drugs of choice in the prevention of recurrent attacks of rheumatic fever. In patients who are allergic to penicillin and sulfonamides, oral erythromycin is recommended by the American Heart Association in the long-term prophylaxis of streptococcal pharyngitis (for the prevention of recurrent attacks of rheumatic fever).3
What are the side effects of Eryped?
The most frequent side effects of oral erythromycin preparations are gastrointestinal and are dose-related. They include nausea, vomiting, abdominal pain, diarrhea and anorexia. Symptoms of hepatitis, hepatic dysfunction and/or abnormal liver function test results may occur.
Onset of pseudomembranous colitis symptoms may occur during or after antibiotic treatment.
Erythromycin has been associated with QT prolongation and ventricular arrhythmias, including ventricular tachycardia and torsades de pointes.
Allergic reactions ranging from urticaria to anaphylaxis have occurred. Skin reactions ranging from mild eruptions to erythema multiforme, Stevens- (erythromycin ethylsuccinate) Johnson syndrome, and toxic epidermal necrolysis have been reported rarely.
There have been rare reports of pancreatitis and convulsions.
There have been isolated reports of reversible hearing loss occurring chiefly in patients with renal insufficiency and in patients receiving high doses of erythromycin.
What is the dosage for Eryped?
Erythromycin ethylsuccinate suspensions and Filmtab tablets may be administered without regard to meals.
Age, weight, and severity of the infection are important factors in determining the proper dosage. In mild to moderate infections the usual dosage of erythromycin ethylsuccinate for children is 30 to 50 mg/kg/day in equally divided doses every 6 hours. For more severe infections this dosage may be doubled. If twice-a-day dosage is desired, one-half of the total daily dose may be given every 12 hours. Doses may also be given three times daily by administering one-third of the total daily dose every 8 hours.
The following dosage schedule is suggested for mild to moderate infections:
|Body Weight||Total Daily Dose|
|Under 10 lbs||30-50 mg/kg/day
15-25 mg/kg/q 12 h
|10 to 15 lbs||200 mg|
|16 to 25 lbs||400 mg|
|26 to 50 lbs||800 mg|
|51 to 100 lbs||1200 mg|
|over 100 lbs||1600 mg|
400 mg erythromycin ethylsuccinate every 6 hours is the usual dose. Dosage may be increased up to 4 g per day according to the severity of the infection. If twice-a-day dosage is desired, one-half of the total daily dose may be given every 12 hours. Doses may also be given three times daily by administering one-third of the total daily dose every 8 hours.
For adult dosage calculation, use a ratio of 400 mg of erythromycin activity as the ethylsuccinate to 250 mg of erythromycin activity as the stearate, base or estolate.
In the treatment of streptococcal infections, a therapeutic dosage of erythromycin ethylsuccinate should be administered for at least 10 days. In continuous prophylaxis against recurrences of streptococcal infections in persons with a history of rheumatic heart disease, the usual dosage is 400 mg twice a day.
For Treatment of Urethritis Due to C. trachomatis or U. urealyticum
800 mg three times a day for 7 days.
For Treatment of Primary Syphilis
Adults: 48 to 64 g given in divided doses over a period of 10 to 15 days.
For Intestinal Amebiasis
400 mg four times daily for 10 to 14 days.
30 to 50 mg/kg/day in divided doses for 10 to 14 days.
For Use in Pertussis
Although optimal dosage and duration have not been established, doses of erythromycin utilized in reported clinical studies were 40 to 50 mg/kg/day, given in divided doses for 5 to 14 days.
For Treatment of Legionnaires' Disease
Although optimal doses have not been established, doses utilized in reported clinical data were those recommended above (1.6 to 4 g daily in divided doses.)
What drugs interact with Eryped?
Erythromycin use in patients who are receiving high doses of theophylline may be associated with an increase in serum theophylline levels (erythromycin ethylsuccinate) and potential theophylline toxicity. In case of theophylline toxicity and/or elevated serum theophylline levels, (erythromycin ethylsuccinate) the dose of theophylline should be reduced while the patient is receiving concomitant erythromycin therapy.
Concomitant administration of erythromycin and digoxin has been reported to result in elevated digoxin serum levels. (erythromycin ethylsuccinate)
There have been reports of increased anticoagulant effects when erythromycin and oral anticoagulants were used concomitantly. Increased anticoagulation effects due to interactions of erythromycin with various oral anticoagulants may be more pronounced in the elderly.
Erythromycin is a substrate and inhibitor of the 3A isoform subfamily of the cytochrome p450 enzyme system (CYP3A). Coadministration of erythromycin and a drug primarily metabolized tions. Interactions with other drugs metabolized by the CYP3A isoform are also possible. The following CYP3A based drug interactions have been observed with erythromycin products in post-marketing experience:
Concurrent use of erythromycin and ergotamine or dihydroergotamine has been associated in some patients with acute ergot toxicity characterized by severe peripheral vasospasm and dysesthesia.
Triazolobenzodiazepines (such as triazolam and alprazolam) and related benzodiazepines
HMG-CoA Reductase Inhibitors
Erythromycin has been reported to increase concentrations of HMG-CoA reductase inhibitors (e.g., lovastatin and simvastatin). Rare reports of rhabdomyolysis have been reported in patients taking these drugs concomitantly.
There have been spontaneous or published reports of CYP3A based interactions of erythromycin with cyclosporine, carbamazepine, tacrolimus, alfentanil, disopyramide, rifabutin, quinidine, methylprednisolone, cilostazol, vinblastine, and bromocriptine.
In addition, there have been reports of interactions of erythromycin with drugs not thought to be metabolized by CYP3A, including hexobarbital, phenytoin, and valproate.
Erythromycin has been reported to significantly alter the metabolism of the nonsedating antihistamines terfenadine and astemizole when taken concomitantly. Rare cases of serious cardiovascular adverse events, including electrocardiographic QT/QTc interval prolongation, cardiac arrest, torsades de pointes, and other ventricular arrhythmias have been observed. In addition, deaths have been reported rarely with concomitant administration of terfenadine and erythromycin.
There have been post-marketing reports of drug interactions when erythromycin is co-administered with cisapride, resulting in QT prolongation, cardiac arrhythmias, ventricular tachycardia, ventricular fibrillation, and torsades de pointes, most likely due to inhibition of hepatic metabolism of cisapride by erythromycin. Fatalities have been reported.
Drug/Laboratory Test Interactions
Erythromycin interferes with the fluorometric determination of urinary catecholamines.
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Is Eryped safe to take while pregnant or breastfeeding?
There is no evidence of teratogenicity or any other adverse effect on reproduction in female rats fed erythromycin base by oral gavage at 350 mg/kg/day (approximately twice the maximum recommended human dose on a body surface area) prior to and during mating, during gestation, and through weaning. No evidence of teratogenicity or embryotoxicity was observed when erythromycin base was given by oral gavage to pregnant rats and mice at 700 mg/kg/day and to pregnant rabbits at 125 mg/kg/day (approximately 1-3 times the maximum recommended human dose).
Eryped (erythromycin ethylsuccinate) is an antibiotic that treats various bacterial infections of the lungs, skin, intestinal and urinary tracts, among others. Eryped is only effective against bacterial infections. It's use should be tightly controlled -- that is, not used in cases of viruses or for general infection prevention in most cases -- to avoid promoting antibiotic resistance.
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Related Disease Conditions
Urinary Tract Infection (UTI)
A urinary tract infection (UTI) is an infection of the bladder, kidneys, ureters, or urethra. E. coli, a type of bacteria that lives in the bowel and near the anus, causes most UTIs. UTI symptoms include pain, abdominal pain, mild fever, urinary urgency and frequency. Treatment involves a course of antibiotics.
Pneumonia is inflammation of the lungs caused by fungi, bacteria, or viruses. Symptoms and signs include cough, fever, shortness of breath, and chills. Antibiotics treat pneumonia, and the choice of the antibiotic depends upon the cause of the infection.
Chlamydia in Women
Chlamydia is the most common sexually transmitted disease in the U.S. Signs and symptoms of chlamydia, a bacterial infection, include vaginal discharge, abdominal pain, burning with urination, blood in the urine, and feelings of urinary urgency and frequency. Untreated chlamydia can cause pelvic inflammatory disease (PID), increased risk of ectopic pregnancy, and infertility. Chlamydia is diagnosed with a culture or by identification of the genetic material of the bacteria. Treatment of chlamydia consists of a course of antibiotics.
Is Chlamydia Contagious?
Chlamydia is a sexually transmitted disease (STD) that is contagious. Chlaymida is spread through sexual contact. (You cannot get chlamyidia from kissing or sharing utensils or drinks.) Chlamydia is the most common STD in the U.S. The incubation period for chlamydia ranges from days to months, and the contagious period ends seven days after patients begin treatment. Chlamydia signs and symptoms may include painful urination, rectal irritation (proctitis), eye infections, and infertility. Women can also develop chronic pelvic pain, salpingitis, and endometritis.
Second Source article from Government
Diphtheria is a disease that causes symptoms and signs such as fever, enlarged lymph nodes, and swallowing problems. Erythromycin is the primary treatment for diphtheria. Vaccines that prevent diphtheria include the DTaP, Tdap, DT, and Td.
Legionellosis is an infection caused by the Legionella pneumophila bacterium. There are two forms of legionellosis: Pontiac fever and Legionnaires' disease, which is the more severe of the two infections. Symptoms of Pontiac fever include fever, headache, muscle aches, and chills. Symptoms of Legionnaires' disease include cough, chills, fever and sometimes muscle aches, headaches, loss of appetite, diarrhea, and severe pneumonia. While Pontiac fever resolves on its own, Legionnaires' disease must be treated with antibiotics.
How Serious Is Chlamydia?
Untreated chlamydia disease, however, can cause serious health problems with both short- and long-term complications.
Treatment & Diagnosis
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Medications & Supplements
- erythromycin (Ery-Tab, PCE)
- erythromycin base, erythromycin stearate - oral, Erythrocin
- erythromycin ethylsuccinate liquid - oral, E.E.S., Eryped
- erythromycin ointment - topical, Akne-Mycin
- erythromycin base enteric coated delayed release - oral, Ery-Tab, Eryc, PCE
- erythromycin base gel - topical, A/T/S, Emgel, Erygel
- erythromycin solution, lotion - topical, A/T/S
- erythromycin base pads - topical, Erycette
- erythromycin/sulfisoxazole suspension - oral, Pediazole
- erythromycin/benzoyl peroxide - topical, Benzamycin
- erythromycin lactobionate - intravenous
- ERYTHROMYCIN ESTOLATE-ORAL LIQUID, Ilosone
- Ofloxacin vs. Erythromycin
- erythromycin and benzoyl peroxide (gel or pak), Benzamycin
- Side Effects of Ery-Tab (erythromycin)
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