ERYTHROMYCIN
(er-ith-roe-mye'sin)
Akne-Mycin Ery-Tab, Apo-Erythro Base, A/T/S, E-Mycin, Eryc, EryDerm, Erythrocin, Erythromid, Erythromycin Base, Ilotycin, Novorythro, PCE, Robimycin, Ro-Mycin, Staticin, T-Stat
Classifications:antiinfective; macrolide antibiotic / Moderate to Severe Infections
Adult:PO 250–500 mg q6h; 333 mg q8h
Child:PO 30–50 mg/kg/d divided q6hTopical Apply ointment to infected eye 1 or more times/d
Neonate:PO7 d, 10 mg/kg q12h; >7 d, 10 mg/kg q8–12hTopical 0.5–1 cm in conjunctival sac once
Chlamydia trachomatis Infections
Adult:PO 500 mg q.i.d. or 666 mg q8h
Child:Topical Apply 0.5–1 cm ribbon in lower conjunctival sacs shortly after birth / Macrolide antibiotic produced by a strain of Streptomyces erythreus. Bacteriostatic or bactericidal, depending on nature of organism and drug concentration used. / Pneumococcal pneumonia, Mycoplasma pneumoniae (primary atypical pneumonia), acute pelvic inflammatory disease caused by Neisseria gonorrhoeae in females sensitive to penicillin, infections caused by susceptible strains of staphylococci, streptococci, and certain strains of Haemophilus influenzae. Also used in intestinal amebiasis, Legionnaires' disease, uncomplicated urethral, endocervical, and rectal infections caused by Chlamydia trachomatis, for prophylaxis of ophthalmia neonatorum caused by N. gonorrhoeae, C. trachomatis, and for chlamydial conjunctivitis in neonates. Considered an acceptable alternative to penicillin for treatment of streptococcal pharyngitis, for prophylaxis of rheumatic fever and bacterial endocarditis, for treatment of diphtheria as adjunct to antitoxin and for carrier state, and as alternate choice in treatment of primary syphilis in patients allergic to penicillins. Topical applications: Pyodermas, acne vulgaris, and external ocular infections, including neonatal chlamydial conjunctivitis and gonococcal ophthalmia. / GI:Nausea, vomiting, abdominal cramping, diarrhea, heartburn, anorexia. Body as a Whole: Fever, eosinophilia, urticaria, skin eruptions, fixed drug eruption, anaphylaxis. Superinfections by nonsusceptible bacteria, yeasts, or fungi. Special Senses: Ototoxicity: reversible bilateral hearing loss, tinnitus, vertigo. Digestive: (Estolate) Cholestatic hepatitis syndrome. Skin: (topical use) Erythema, desquamation, burning, tenderness, dryness or oiliness, pruritus. / Hypersensitivity to erythromycins. Estolate: History of erythromycin-associated hepatitis; liver dysfunction; treatment of skin disorders such as acne or furunculosis; prophylaxis of rheumatic fever. / Assessment & Drug Effects
- Report onset of GI symptoms after PO administration to physician. These are dose related; if symptoms persist after dosage reduction, physician may prescribe drug to be given with meals in spite of impaired absorption.
- Monitor for adverse GI effects. Pseudomembranous enterocolitis (see Appendix F), a potentially life-threatening condition, may occur during or after antibiotic therapy.
- Observe for S&S of superinfection by overgrowth of nonsusceptible bacteria or fungi. Emergence of resistant staphylococcal strains is highly predictable during prolonged therapy.
- Lab tests: Periodic liver function tests during prolonged therapy.
- Monitor for S&S of hepatotoxicity. Premonitory S&S include: Abdominal pain, nausea, vomiting, fever, leukocytosis, and eosinophilia; jaundice may or may not be present.
- Monitor for ototoxicity that appears to develop most frequently in patients receiving 4 g/d or more, older adults, female patients, and patients with kidney or liver dysfunction. It is reversible with prompt discontinuation of drug.