Erythromycin (Erythromycin Base) - Summary

ERYTHROMYCIN SUMMARY

ERYTHROMYCIN
Base Filmtab®
(erythromycin tablets, USP)

Erythromycin Base Filmtab (erythromycin tablets, USP) is an antibacterial product containing erythromycin, USP, in a unique, nonenteric film coating for oral administration.

To reduce the development of drug-resistant bacteria and maintain the effectiveness ofErythromycin Base Filmtab tablets and other antibacterial drugs, Erythromycin Base Filmtab tablets should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Erythromycin Base Filmtab tablets are indicated in the treatment of infections caused by susceptible strains of the designated microorganisms in the diseases listed below:

Upper respiratory tract infections of mild to moderate degree caused by Streptococcus pyogenes; Streptococcus pneumoniae; 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 pyogenes or Streptococcus pneumoniae.

Listeriosis caused by Listeria monocytogenes.

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).

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.

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: Erythrocin® Lactobionate-I.V. (erythromycin lactobionate for injection, USP) followed by erythromycin base orally, 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.

Erythromycins are indicated for treatment of the following infections caused by Chlamydia trachomatis: conjunctivitis of the newborn, pneumonia of infancy, and urogenital infections during pregnancy. When tetracyclines are contraindicated or not tolerated, erythromycin is indicated for the treatment of uncomplicated urethral, endocervical, or rectal infections in adults due to Chlamydia trachomatis.³

When tetracyclines are contraindicated or not tolerated, erythromycin is indicated for the treatment of nongonococcal urethritis caused by Ureaplasma urealyticum.³

Primary syphilis caused by Treponema pallidum. Erythromycin (oral forms only) is an alternative choice of treatment for primary syphilis in patients allergic to the penicillins. In treatment of primary syphilis, spinal fluid should be examined before treatment and as part of the follow-up after therapy.

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).³ Erythromycin is indicated for the treatment of penicillin-allergic patients. The therapeutic dose should be administered for ten 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

See all indications & dosage >>

NEWS HIGHLIGHTS

Published Studies Related to Erythromycin

Erythromycin establishes early oral feeding in neonates operated for congenital intestinal atresias. [2009.04]
PURPOSE: The recovery of gastrointestinal function following surgery for congenital intestinal atresias can be prolonged and may increase morbidity and hospital stay. This study was conducted to investigate the prokinetic effect of erythromycin in neonates undergoing surgery for small bowel atresias... CONCLUSION: The administration of oral erythromycin following primary anastomosis for small intestinal atresias results in early recovery of intestinal function, fewer days on TPN and a trend for shorter hospital stay.

Effect of oral erythromycin therapy in patients with aseptic loosening of joint prostheses. [2009.04]
There is currently no cure for aseptic loosening (AL) of total joint replacement (TJR) except surgical revision. The purpose of this study was to determine whether oral EM could improve the periprosthetic tissue profiles and reduce serum cytokine production in AL patients who are candidates for surgical revision...

Long-term erythromycin therapy is associated with decreased chronic obstructive pulmonary disease exacerbations. [2008.12.01]
RATIONALE: Frequent chronic obstructive pulmonary disease (COPD) exacerbations are a major cause of hospital admission and mortality and are associated with increased airway inflammation. Macrolides have airway antiinflammatory actions and may reduce the incidence of COPD exacerbations. OBJECTIVES: To determine whether regular therapy with macrolides reduces exacerbation frequency... CONCLUSIONS: Macrolide therapy was associated with a significant reduction in exacerbations compared with placebo and may be useful in decreasing the excessive disease burden in this important patient population. Clinical trial registered with www.clinicaltrials.gov (NCT 00147667).

Oral amoxicillin vs. oral erythromycin in the treatment of pyoderma in Bamako, Mali: an open randomized trial. [2007.10]
BACKGROUND: Pyoderma (bacterial superficial skin infection) is an extremely common disorder in tropical developing countries. In these settings, Streptococcus pyogenes is considered to be the main etiological agent. Apart from epidemics of poststreptococcal glomerulonephritis where mass treatment with intramuscular benzathine-penicillin is recommended, no recommendation exists for the treatment of pyoderma in this setting. The aim of this study was to evaluate the efficacy of oral amoxicillin in the treatment of pyoderma in Mali, by comparison with oral erythromycin... CONCLUSIONS: Amoxicillin was as efficacious as erythromycin in the treatment of severe pyoderma in Mali. Owing to its efficacy, added to high availability and low cost, this compound should be considered a first-line treatment of this disorder in this country, and perhaps in other countries where this condition presents in a similar way.

Oral erythromycin accelerates impaired gastrointestinal motility after endoscopic mucosal resection. [2007.09]
Gastrointestinal motility may be impaired after endoscopic mucosal resection of gastric lesions. We investigated whether oral erythromycin could improve motility... Postprandial and fasting gastrointestinal motility were impaired after endoscopic resection, and postprandial as well as fasting motility were improved by oral erythromycin.

more studies >>

Clinical Trials Related to Erythromycin

The Effect of Concomitant Administration of Erythromycin and Diltiazem on CYP3A Activity in Healthy Volunteers [Completed]
We, the researchers at the Indiana University School of Medicine, are doing this study to better understand how the effects of certain medications are altered when taken simultaneously, or in combination with each other. We will also look at how each volunteer's genes (DNA) may affect the way these medications are metabolized.

Hypothesis:

We will test the hypothesis that the extent of drug-drug interaction caused by the combination of erythromycin and diltiazem is not predictable from the extent of interaction produced by each inhibitor alone. Specifically we will test the hypothesis that the combination of erythromycin and diltiazem will cause a greater decrease in midazolam intravenous and oral clearance than the sum of the decreases caused by each inhibitor alone.

An Open, Prospective, Randomized, Multicenter Study of the Efficacy and Safety of Intravenous Followed by Oral Azithromycin Versus Cefuroxime Alone or With Oral Erythromycin for the Treatment of Chinese Patients Who Were Hospitalized for Pneumonia [Completed]
To validate the efficacy and safety of azithromycin for the treatment of Chinese patients hospitalized with community-acquired pneumonia (CAP), compared with cefuroxime or the combination of cefuroxime plus oral erythromycin.

Use of Erythromycin in Mustard-Induced Bronchiolitis [Completed]
We looked for the effectiveness of low-dose long-term prescription of erythromycin in mustard-induced bronchiolitis obliterans

The Effect of Intravenous Erythromycin on Gastric Emptying in Non-Fasted Patients Before Emergency Total Anesthesia [Recruiting]
Urgent or emergency surgery requires that fasting rules observed in elective settings are not respected. Patients in the emergency situation have often ingested food or liquids in their stomach and may have swallowed blood from oral or nasal injuries. Also, gastric emptying is delayed due to the stress of trauma. Patients who are anesthetized in such conditions are at risk of "vomiting" (regurgitation) during the start of anesthesia and that the content of the stomach reaches the trachea and lungs (this is called bronchoaspiration). Fortunately the incidence of aspiration is low, about 1. 4 to 6 in 10'000 anaesthetics, and about 1 in 100'000 patients is likely to die due to aspiration. Thus, although episodes of broncho-aspiration are rare, efficacious prevention of this potentially lethal complication is important. One method to reduce the risk of broncho-aspiration during induction of anaesthesia is the pharmacological reduction of the gastric content (i. e. pre-treatment). The intention of this study is to investigate the efficacy of erythromycin in emptying the stomach of non-fasted surgical patients before induction of anaesthesia in the emergency setting.

Effectiveness of Antibiotic Treatment for Reducing Binge Eating and Improving Digestive Function in People With Bulimia Nervosa [Recruiting]
This study will determine the effectiveness of the antibiotic erythromycin in enhancing gastrointestinal function and decreasing the frequency of binge eating in people with bulimia nervosa.

more trials >>

PATIENT REVIEWS / RATINGS / COMMENTS

Erythromycin review by 46 year old female patient
		Rating
Overall rating:
Effectiveness:		Moderately Effective
Side effects:		Moderate Side Effects
		Treatment Info
Condition / reason:		sinus infection
Dosage & duration:		400 mg taken q 6hrs for the period of 7 days
Other conditions:		cough
Other drugs taken:		sudafed
		Reported Results
Benefits:		I was able to get rid of an infection that had been bothering for awhile.
Side effects:		I developed a rash across my stomach within 45 min. of the first dose and began itching.
Comments:		I was given Erythromycin every time I developed a sinus infection. (This had been going on since childhood). I was also given sudafed to treat allergy symptoms and sometimes a saline solution to flush out my sinuses.

Erythromycin review by 58 year old female patient
		Rating
Overall rating:
Effectiveness:		Highly Effective
Side effects:		Severe Side Effects
		Treatment Info
Condition / reason:		Possible Pertusis
Dosage & duration:		500MG taken every 6 hours for the period of 4 days
Other conditions:		none
Other drugs taken:		none
		Reported Results
Benefits:		It did clear up the infection even in the time frame I used it.
Side effects:		I had severe stomach cramps and rapid heart beat. Seemed to make me feel very thirsty and somewhat faint feeling. Did not feel well at all. My coughing and infection dramatically subsided, however, the side effects made me feel so badly I quit taking it.
Comments:		This was prescribed to me for possible whooping cough...due to exposure to Pertusis through my daughter. Even though my older daughter had received the Pertusis vaccine she still was finally diagnosed as having whooping cough. It took several doctors to finally catch what she had. In the meantime she was very sick...had several z-packs and failed to respond. I came down with a bad cold shortly thereafter and as a precaution I was given the Erythromycin [different doctor than the one she went to].

Erythromycin review by 45 year old female patient
		Rating
Overall rating:
Effectiveness:		Ineffective
Side effects:		Moderate Side Effects
		Treatment Info
Condition / reason:		bladder infection
Dosage & duration:		do not remember 1 or 2x day (dosage frequency: as prescribed) for the period of 1 day
Other conditions:		none
Other drugs taken:		none
		Reported Results
Benefits:		none. I only took the prescription for 1 day
Side effects:		My entire body broke out in a red, itchy rash that was not relieved by scratching nor by topical agents. I reported the reaction to the pharmacist and to my doctor, both of whom told me to cease using the antibiotic immediately as continued use in the presence of the adverse reaction could be very dangerous.
Comments:		The erythromicin was changed to amoxycillin, which I used safely and effectively for 5 to seven days and experience complete relief from symptoms of the bladder infection for which I was being treated.