- What is erythromycin, and how does it work (mechanism of action)?
- What are the uses for erythromycin?
- What are the side effects of erythromycin?
- What is the dosage for erythromycin? Should I take it with food?
- Which drugs or supplements interact with erythromycin?
- Is erythromycin safe to take if I'm pregnant or breastfeeding?
- What else should I know about erythromycin?
What is erythromycin, and how does it work (mechanism of action)?
Erythromycin, like all macrolide antibiotics, prevents bacterial cells from growing and multiplying by interfering with their ability to make proteins while not affecting human cells. Bacteria such as Haemophilus influenzae are resistant to erythromycin alone and must be treated with a combination of erythromycin and adequate doses of sulfonamides.
The FDA approved E.E.S in April 1965.
What are the uses for erythromycin?
Erythromycin is used to treat:
- Streptococcal infections of the throat ("strep throat") and skin
- Lung infections, for example, pneumonia caused by streptococcal pneumoniae, mycoplasma pneumoniae, and legionella pneumophila (legionnaires disease)
- Pelvic inflammatory disease
- Whooping cough
- Intestinal amebiasis
Erythromycin is used in patients who are allergic to penicillin for the prevention of recurrent rheumatic fever and infections of the hearts' valves (endocarditis) in patients with valvular abnormalities of the heart before they undergo dental treatments.
What are the side effects of erythromycin?
The most frequent side effects of erythromycin are
These gastrointestinal side effects are usually dose-related, i.e., more pronounced with higher doses.
Allergic reactions such as
What is the dosage for erythromycin? Should I take it with food?
- The usual dosage for adults is 250 mg every 6 hours, 333 mg every 8 hours or 500 mg every 12 hours. Doses may be increased up to 4 g/day according to the severity of the infection.
- In children, the usual dosage is 30 to 50 mg/kg/day with age, weight, and severity of the infection being taken into consideration to determine the appropriate dosage.
- Erythromycin may be taken with or without food; however optimal blood levels of erythromycin are obtained when taken on an empty stomach (at least 30 minutes and preferably 2 hours before or after meals).
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Which drugs or supplements interact with erythromycin?
Erythromycin when used with antiarrhythmic drugs such as, amiodarone (Cordarone), bretylium (Bretylol), disopyramide (Norpace), dofetilide (Tikosyn), procainamide (Pronestyl), quinidine (Quinaglute, Quinidex, Quinora) and sotalol (Betapace) exaggerates the effect of the antiarrhythmic drugs which may give rise to abnormal heart rhythms such as torsades de pointes.
Theophyllines such as theophylline (Theo-Dur), oxtriphylline (Choledyl SA), and aminophylline (Phyllocontin) reduce erythromycin blood levels by increasing elimination of erythromycin by the kidneys, which may reduce the effectiveness of erythromycin. Conversely, erythromycin inhibits the metabolism (breakdown) of theophyllines by the liver and causes an increase in blood levels of theophylline. High theophylline levels may give rise to side effects such as seizures and disturbances in heart rhythm. Therefore, the dose of theophyllines should be reduced or theophylline levels in the blood should be measured in patients taking erythromycin.
Combining erythromycin with ergotamine or ydroergotamine has been associated with acute ergot toxicity. This combination should be avoided.
Erythromycin prevents digoxin (Lanoxin) from being eliminated by the kidneys; this in turn causes increased levels of digoxin in the blood. Increased levels of digoxin can cause disturbances in heart rhythm. Therefore, it is important to monitor and adjust digoxin doses when treating with erythromycin.
Erythromycin prevents the elimination of warfarin (Coumadin) from the body which can raise the levels of warfarin in the blood. Warfarin is an anticoagulant or blood thinner, and an increase in its level in blood can increase the risk of bleeding. It is important to monitor the effects of warfarin and adjust warfarin doses when treating with erythromycin.
Erythromycin inhibits the breakdown of HMG-CoA reductase inhibitors (statins) such as atorvastatin (Lipitor), lovastatin (Mevacor) and simvastatin (Zocor) by the liver leading to increased levels of statins in the blood. High levels of statins could result in severe myopathy (muscle damage) with rhabdomyolysis (r (rapid breakdown of skeletal muscle) that may damage the kidneys or even lead to death. Erythromycin also can elevate blood levels of some anti-seizure drugs such as carbamazepine (Tegretol) by preventing the breakdown of the anti-seizure drug by the liver. Therefore, doses of the anti-seizure drugs may need to be reduced during treatment with erythromycin. Erythromycin also increases blood levels of sildenafil (Viagra). The dose of sildenafil should be reduced when treating with erythromycin.
Grapefruit juice may prevent the breakdown of erythromycin, resulting in elevated levels of erythromycin in the blood. Therefore, it is important to avoid eating grapefruit or drinking grapefruit juice during treatment with erythromycin.
Is erythromycin safe to take if I'm pregnant or breastfeeding?
- Erythromycin crosses the placenta, but its level in the blood of the fetus is low. There are no adequate studies in pregnant women, hence pregnant women should only use erythromycin if it is felt that the benefits of treatment outweigh the potential but unknown risks.
- Erythromycin is excreted in breast milk; however, erythromycin is considered by the American Academy of Pediatrics to be compatible with breastfeeding. Caution should be exercised, however, when erythromycin is prescribed to women who are breastfeeding.
What else should I know about erythromycin?
What preparations of erythromycin are available?
Erythromycin is available as:
- Tablets: 250, 333, 400 and 500 mg.
- Suspension: 200 and, 400 mg/teaspoon.
- Tablet (Chewable): 200 mg. Powder: 100 mg/half-teaspoon and 200 mg/teaspoon.
- Granules: 200 and 400 mg/teaspoon.
- Powder for Injection: 500 mg and 1g.
How should I keep erythromycin stored?
Erythromycin should be stored at temperatures below 86 F (30 C). It is important to protect tablets from moisture and excessive heat.
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Erythromycin (Ery-Tab, PCE) is an antibiotic prescribed to treat a variety of infections. Side effects, drug interactions, dosage, storage, and pregnancy safety information should be reviewed prior to taking this medication.
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Acne is a localized skin inflammation as a result of overactivity of oil glands at the base of hair follicles. This inflammation, depending on its location, can take the form of a superficial pustule (contains pus), a pimple, a deeper cyst, congested pores, whiteheads, or blackheads. Treatments vary depending on the severity of the acne.
Aortic Valve Stenosis (Symptoms, Causes, Surgery)
Aortic valve stenosis is an abnormal narrowing of the aortic valve of the heart. The causes of aortic stenosis are wear and tear of the valve in the elderly, congenital, or scarring or scarring of the aortic valve from rheumatic fever. Symptoms include angina, fainting, and shortness of breath. Treatment is dependant upon the severity of the condition.
Clostridium Difficile Colitis (Antibiotic-Associated Colitis, C. difficile colitis)
Clostridium difficile (C. difficile) is a bacterium, and is one of the most common causes of infection of the colon. C. difficile spores are found frequently in hospitals, nursing homes, extended care facilities, and nurseries for newborn infants. They can be found: on bedpans, furniture, toilet seats, linens, telephones, stethoscopes, fingernails, rings, floors, infants' rooms, and diaper pails. They even can be carried by pets. Antibiotic-associated (C. difficile) colitis is an infection of the colon caused by C. difficile that occurs primarily among individuals who have been using antibiotics. Treatment for C. difficile colitis includes: hydration, replenishment of electrolyte deficiencies, discontinuing the antibiotic that caused the colitis, and using antibiotics to eradicate the C. difficile bacterium.
Influenza (flu) is a respiratory illness caused by a virus. Flu symptoms include fever, cough, sore throat, runny nose, headache, fatigue, and muscle aches. The flu may be prevented with an annual influenza vaccination.
Intestinal Gas (Belching, Bloating, Flatulence)
Gas (intestinal gas) means different things to different people. Everyone has gas and eliminates it by belching, burping, or farting (flatulence). Bloating or abdominal distension is a subjective feeling that the stomach is larger or fuller than normal. Belching or burping occurs when gas is expelled from the stomach out through the mouth. Flatulence or farting occurs when intestinal gas is passed from the anus. Causes of belching or burping include drinking too rapidly, anxiety, carbonated drinks, habit, and swallowing air. Learn about causes of intestinal gas, foods that cause gas and bloating, treatments that reduce excessive gas and soothe gas pain, and much more.
Lyme disease is a bacterial illness, which is spread by ticks when they bite the skin. Initially the disease affects the skin causing a reddish rash associated with flu-like symptoms. It takes weeks to months after the initial redness of the skin for its effects to spread throughout the body. Lyme disease can be treated with antibiotics. Lyme disease can be prevented by using tick avoidance techniques.
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Pinkeye, also called conjunctivitis, is redness or irritation of the conjunctivae, the membranes on the inner part of the eyelids and the membranes covering the whites of the eyes. These membranes react to a wide range of bacteria, viruses, allergy-provoking agents, irritants, and toxic agents.
Pneumonia (Symptoms, Causes, Types, Treatment, and Recovery)
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Prostatitis (Inflammation of the Prostate Gland)
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Rosacea is a skin disease that causes redness of the forehead, chin, and lower half of the nose. In addition to inflammation of the facial skin, symptoms include dilation of the blood vessels and pimples (acne rosacea) in the middle third of the face. Oral and topical antibiotics are treatments for rosacea. If left untreated, rhinophyma (a disfiguring nose condition) may result.
Scleroderma is an autoimmune disease of the connective tissue. It is characterized by the formation of scar tissue (fibrosis) in the skin and organs of the body, leading to thickness and firmness of involved areas. Scleroderma is also referred to as systemic sclerosis, and the cause is unknown. Treatment of scleroderma is directed toward the individual features that are most troubling to the patient.
Sexually Transmitted Diseases in Women (STDs)
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Strep Throat (Treatment, Causes, Home Remedies)
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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.
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Staph Infection (Staphylococcus Aureus)
Staphylococcus or staph is a group of bacteria that can cause a multitude of diseases. Staph infections can cause illness directly by infection or indirectly by the toxins they produce. Symptoms and signs of a staph infection include redness, swelling, pain, and drainage of pus. Minor skin infections are treated with an antibiotic ointment, while more serious infections are treated with intravenous antibiotics.
Whooping Cough (Pertussis)
Whooping cough (pertussis) is highly contagious respiratory infection that is caused by the bacteria Bordetella pertussis. There are an estimated 300,000 plus deaths annually from whooping cough (pertussis). Whooping cough commonly affects infants and young children but can be prevented with immunization with the vaccine. First stage whooping cough symptoms are a runny nose, sneezing, low-grade fever, a mild cough with the cough gradually becoming more severe. After one to two weeks, the second stage of whooping cough begins.
Anthrax is a deadly infectious disease that may be transmitted to humans by infected animals or by biological warfare. There are three types of anthrax: cutaneous, inhalation, and gastrointestinal. Symptoms of cutaneous anthrax include a swollen glands, muscle ache, headache, fever, nausea, vomiting, and a red-brown raised spot that enlarges, blisters, and hardens, forming an ulcer crater with black crust. Symptoms of inhalation anthrax are flu-like and may progress to respiratory distress, shock, coma, and death. Symptoms of gastrointestinal anthrax include loss of appetite, bloody diarrhea, and abdominal pain. Treatment for cutaneous anthrax involves penicillin, tetracycline, erythromycin, and ciprofloxin. Inhalation anthrax necessitates treatment with IV therapy with antibiotics.
Gonorrhea In Women
Gonorrhea is a bacterial infection transmitted during sexual contact. In women, symptoms include a yellow vaginal discharge, burning or frequent urination, and redness, swelling, burning and itching of the vaginal area. Gonorrhea can be treated with injectable (penicillin) or oral medications.
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.
Syphilis in Women
Syphilis is a sexually transmitted disease (STD) caused by a spiral-shaped type of bacteria known as a spirochete. There are three stages of syphilis with distinct symptoms. During first stage of syphilis, a painless ulcer known as a chancre forms. Irreversible organ damage can occur during the late stage of syphilis. Special blood tests are used to diagnose syphilis. Syphilis infection is treated with penicillin. Condom use can often prevent syphilis.
Yaws is an infectious disease that mainly occurs in the tropical areas of South and Central America, Asia, Africa, and the Pacific Islands. The disease is caused by a bacterium called Treponema pertenue, which causes lesions that look like bumps on the skin of the feet, hands, face, and genital area. Yaws is treated with penicillin or another antibiotic.
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Gastroparesis is a medical condition in which the muscle of the stomach is paralyzed by a disease of either the stomach muscle itself or the nerves controlling the muscle. As a consequence, food and secretions do not empty normally from the stomach. Gastroparesis symptoms are nausea and vomiting; abdominal bloating, and pain can result.
Heart Attack Prevention
Heart disease and heart attacks can be prevented by leading a healthy lifestyle with diet, exercise, and stress management. Symptoms of heart attack in men and women include chest discomfort and pain in the shoulder, neck, jaw, stomach, or back. Women experience the same symptoms as men; however, they also may experience: Extreme fatigue Pain in the upper abdomen Dizziness Fainting Leading a healthy lifestyle with a heart healthy low-fat diet, and exercise can help prevent heart disease and heart attack.
Indigestion (Dyspepsia, Upset Stomach Pain)
Indigestion (dyspepsia) can be caused by diseases or conditions that involve the gastrointestinal (GI) tract, and also by some diseases and conditions that do not involve the GI tract. Indigestion can be a chronic condition in which the symptoms fluctuate in frequency and intensity. Signs and symptoms that accompany indigestion include pain in the chest, upper abdominal pain, belching, nausea, bloating, abdominal distention, feeling full after eating only a small portion of food, and rarely, vomiting.
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.
Impetigo: Symptoms, Transmission, Treatment, and Cure
Impetigo is a contagious skin infection caused by staph and strep bacteria. There are two types of impetigo: nonbullous and bullous. Symptoms of nonbullous impetigo include small blisters on the nose, face, arms, or legs and possibly swollen glands. Bullous impetigo signs include blisters in various areas, particularly in the buttocks area. Treatment involves gentle cleansing, removing the crusts of popped blisters, and the application of prescription-strength mupirocin antibiotic ointment.
STDs in Men
Sexually transmitted diseases (STDs) are infections transmitted during sexual contact. They may be caused by viruses, bacteria, or parasites. STDs in men cause no symptoms or symptoms like genital burning, itching, sores, rashes, or discharge. Common infections that are sexually transmitted in men include gonorrhea, chlamydia, syphilis, hepatitis C and B, genital warts, human papillomavirus (HPV), and genital herpes. Some STDs in men are treatable while others are not. STDs are diagnosed with tests that identify proteins or genetic material of the organisms causing the infection. The prognosis of an STD depends on whether the infection is treatable or not. Use of latex condoms can help reduce the risk of contracting an STD but it does not eliminate the risk entirely.
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GERD and GER (Acid Reflux) in Infants and Children
GERD (gastroesophageal reflux disease) is the upward movement of stomach content, including acid, into the esophagus and sometimes into or out of the mouth. Common symptoms of GERD in children include colic, feeding problems, poor growth, frequent vomiting or coughing, heartburn, regurgitation, recurrent wheezing, pneumonia, choking, or gagging. Treatment may involve elevating the child's bed, keeping the child upright after eating, limiting foods that seem to make the reflux worse, encouraging your child to exercise, and serving several small meals a day.
Sexually Transmitted Diseases and Pregnancy (STDs)
When you are pregnant, many sexually transmitted diseases (STDs) can be especially harmful to you and your baby. These STDs include herpes, HIV/AIDS, genital warts (HPV), hepatitis B, chlamydia, syphilis, gonorrhea, and trichomoniasis. Symptoms include bumps, sores, warts, swelling, itching, or redness in the genital region. Treatment of STDs while pregnant depends on how far along you are in the pregnancy and the progression of the infection.
Dry eyes are caused by an imbalance in the tear-flow system of the eye, but also can be caused by the drying out of the tear film. This can be due to dry air created by air conditioning, heat, or other environmental conditions. Treatment may involve self-care measures, medications, or rarely, surgery.
Pericoronitis is inflammation of the gum tissue around the molars. Pericoronitis commonly occurs in teens or young people when the wisdom teeth erupt. Symptoms include pain, swelling, swollen lymph nodes, and difficulty opening the mouth. Pericoronitis can be diagnosed by a dentist and is treated with pain medication. Severe cases may be treated with surgery.
Group A streptococcal infections are caused by group A streptococcus, a bacteria that causes a variety of health problems, including strep throat, impetigo, cellulitis, erysipelas, and scarlet fever. There are more than 10 million group A strep infections each year.
Pelvic Inflammatory Disease (PID)
Pelvic inflammatory disease (PID) is the most common and serious complication of sexually transmitted diseases (STDs), aside from AIDS, among women. The signs and symptoms of pelvic inflammatory disease include: fever, vaginal discharge with a foul odor, abdominal pain, including pain during intercourse, and irregular vaginal bleeding. Pelvic inflammatory disease can scar the Fallopian tubes, ovaries, and related structures and lead to ectopic pregnancies, infertility, chronic pelvic pain, and other serious consequences. Pelvic inflammatory disease treatment includes several types of antibiotics.
Vancomycin-Resistant Enterococci (VRE)
Vancomycin-resistant enterococci (VRE) infection is the most common type of infection acquired by patients while hospitalized. Patients at risk for VRE are those who are already ill, and hospitalized, including individuals with diabetes, elderly, ICU patients, kidney failure patients, or patients requiring catheters. Enterococci can survive for months in the digestive tract and female genital tract. Other risk factors for acquiring VRE include those how have been previously treated with vancomycin and combinations of other antibiotics. Treatment of VRE is generally with other antibiotics other than vancomycin. Prevention of VRE can be achieved by proper hand hygiene.
Abnormal Heart Rhythms (Heart Rhythm Disorders)
Heart rhythm disorders vary from minor palpitations, premature atrial contractions (PACs), premature ventricular contractions (PVCs), sinus tachycardia, and sinus brachycardia, to abnormal heart rhythms such as tachycardia, ventricular fibrillation, ventricular flutter, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), Wolf-Parkinson-White syndrome, brachycardia, or heart blocks. Treatment is dependent upon the type of heart rhythm disorder.
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.
Rheumatic fever is a disease that sometimes occurs after a group A streptococcal infection of the throat. Symptoms and signs include carditis, polyarthritis, Aschoff bodies, rash, Sydenham's chorea, and fever. Treatment for rheumatic fever involves eliminating the bacteria with penicillin, erythromycin, or azithromycin. Further treatment focuses on alleviating the symptoms brought on by the body's immunologic response to the bacteria.
Pityriasis rosea is a rash that begins with a large pink patch with well-defined scaly borders on the back, chest, or neck. In one to two weeks, the person will develop many smaller pink patches on his or her trunk, arms, and legs. Symptoms include mild itching and possible sore throat, fatigue, nausea, aching, and decreased appetite. Pityriasis rosea typically resolves on its own and symptoms and signs may be treated with topical steroid creams and oral antihistamines.
Ingrown hairs may be caused by improper shaving, waxing, or blockage of the hair follicle. Symptoms and signs of ingrown hairs include itching, tenderness, and small red pus bumps. Ingrown hairs usually heal on their own, but topical antibiotics, chemical depilatories, and hair-removal laser may be used in the treatment of ingrown hairs.
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.
Cystic acne is distinguised by painful nodules on the chest, face, neck, and back. This form of acne is known to scar. Treatment may incorporate the use of hormonal therapies, oral antibiotics, and prescription medications.
Hailey-Hailey Disease (Familial Benign Pemphigus)
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