ERYTHROMYCIN SUMMARY
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 of Erythromycin 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.
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
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NEWS HIGHLIGHTS
Published Studies Related to Erythromycin
Premedication with erythromycin improves endoscopic visualization of the gastric
mucosa in patients with subtotal gastrectomy: a prospective, randomized,
controlled trial. [2014] erythromycin improves gastric mucosa visualization in patients with STG... CONCLUSIONS: Premedication with erythromycin improves mucosal visualization
Effect of long-term, low-dose erythromycin on pulmonary exacerbations among
patients with non-cystic fibrosis bronchiectasis: the BLESS randomized controlled
trial. [2013] IMPORTANCE: Macrolide antibiotics such as erythromycin may improve clinical
outcomes in non-cystic fibrosis (CF) bronchiectasis, although associated risks of
macrolide resistance are poorly defined. OBJECTIVE: To evaluate the clinical efficacy and antimicrobial resistance cost of
low-dose erythromycin given for 12 months to patients with non-CF bronchiectasis
with a history of frequent pulmonary exacerbations...
Randomized double-blind crossover study to determine the effects of erythromycin
on small intestinal nutrient absorption and transit in the critically ill. [2012] on small intestinal nutrient absorption and transit in the critically ill... CONCLUSIONS: Acute administration of erythromycin increases small intestinal
A comparison between the effectiveness of erythromycin, single-dose clarithromycin and topical fusidic acid in the treatment of erythrasma. [2011.09.18] Abstract Although erythrasma is a superficial skin infection, there is no consensus on the treatment model of erythrasma... Conclusion: Topical fusidic acid proved to be the most effective treatment; however, clarithromycin therapy may be an alternative regimen in the treatment of erythrasma because of its efficiency and better patient's compliance.
[Comparison of maternal and perinatal outcomes in the conservative treatment preterm premature membrane rupture between the use of erythromycin and clindamycin]. [2011.07] BACKGROUND: premature rupture of membranes occurs between 5 and 15% of pregnancies, of these, 10% occurs at term and preterm 2 to 3.5%. OBJECTIVE: To compare maternal and perinatal outcomes from the use of erythromycin or clindamycin in women with preterm premature rupture of membranes with conservative treatment at the Regional General Hospital No. 36... CONCLUSIONS: comparing the maternal and perinatal outcomes with conservative management of premature rupture of membranes, results were better in the group treated with erythromycin. It is not possible to prove it statistically because of the sample size.
Clinical Trials Related to Erythromycin
Erythromycin Treatment for Readthrough of APC Gene Stop Codon Mutations in Familial Adenomatous Polyposis [Recruiting]
Colorectal cancer (CRC) is a leading cause for cancer related mortality in the western world
with a lifetime risk of 6%. Etiology is complex, while genetic background significantly
affects the risk. Around one third of all genetic disorders as well as most cases of
Familial Adenomatous Polyposis (FAP) and a large proportion of all sporadic CRC cases occur
as a result of premature nonsense mutations (creating a stop codon) in an individual's
adenomatous polyposis coli (APC) gene. Nonsense mutations are single-point alterations in
the DNA that prematurely halt the protein translation process, producing a shortened,
nonfunctional protein. In many of these cases, if the cell can be 'persuaded' to ignore the
premature stop codon signal, the resulting protein may be able to ameliorate or stop the
disease.
Recently, members of the aminoglycoside family of antibiotics have been found to induce
ribosomal read-through of nonsense mutations, leading to expression of a full length,
functional protein. Investigators have recently shown that members of the aminoglycoside and
macrolide antibiotic families can induce read-through of the nonsense mutations in the APC
gene and lead to reduced oncogenic phenotypes in CRC cells and in different mice models.
The aim of this project is to determine the ability of the macrolide antibiotic-erythromycin
to induce read-through of the nonsense mutations in the APC gene and to induce expression of
a full length, functional APC protein in patients suffering from FAP and to tests its effect
on adenoma number and size and on desmoid tumors in these patients. The future goal is to
maximize the effect of stop-codon suppressors on APC while minimizing side effects.
In this study investigators will select FAP patients which carry APC nonsense mutations,
treat them with erythromycin PO for 4-6 months and examine colonic and duodenal adenomas as
well as abdominal desmoid tumors, that will be documented before during and after treatment.
In parallel, investigators will test polyp, adenoma and desmoid tissue samples as well as
blood samples from these patients for changes in expression levels of the APC protein and
related oncogenic markers.
Suppression of nonsense mutations within the APC gene should be of benefit for patients
suffering from FAP, attenuated FAP or multiple adenomas and for patients with advanced or
diffuse CRC. Furthermore, given the rapid progress being made in the identification of
different nonsense mutations in human genes that lead to mostly un-curable disease, the
identification of clinically approved compounds that suppress nonsense mutations and that
can be administered long-term without significant side effects would open new venues in the
treatment of genetic human diseases that arise from pre-mature stop codons in important
coding sequences.
Immediate goal: establish the ability of erythromycin to read-through APC nonsense mutation
in FAP patients. The read-through effect of erythromycin will be clinically tested by
counting and measuring the number and size of both colonic and duodenal adenomas before and
over treatment and by measuring the size of known desmoid tumors. Samples of the adenomas
and desmoid tumors will be tested by western blot, immunofluorescence and
immunohistochemistry for restoration of APC expression and changes in oncogenic markers.
These experiments should be conducted within 6 month.
Long term objective:
1. Determine the lowest dose of erythromycin that can inhibit growth of colonic neoplasia
and CRC in patients expressing a truncated APC protein due to nonsense mutations.
2. Examine the ability of a panel of additional macrolide antibiotics to induce APC
nonsense mutation suppression using in-vitro methods. Investigators will focus on
macrolide antibiotics that are currently in clinical use and are administrated for long
terms. These objectives should take around 6 month and will be conducted in parallel.
Erythromycin Treatment for Readthrough of APC Gene Stop Codon Mutation in Familial Adenomatous Polyposis-minors' Adjusted Version [Not yet recruiting]
Colorectal cancer (CRC) is a leading cause for cancer related mortality in the western world
with a lifetime risk of 6%. Etiology is complex, while genetic background significantly
affects the risk. Around one third of all genetic disorders as well as most cases of
Familial Adenomatous Polyposis (FAP) and a large proportion of all sporadic CRC cases occur
as a result of premature nonsense mutations (creating a stop codon) in an individual's
adenomatous polyposis coli (APC) gene. Nonsense mutations are single-point alterations in
the DNA that prematurely halt the protein translation process, producing a shortened,
nonfunctional protein. In many of these cases, if the cell can be 'persuaded' to ignore the
premature stop codon signal, the resulting protein may be able to ameliorate or stop the
disease.
Recently, members of the aminoglycoside family of antibiotics have been found to induce
ribosomal read-through of nonsense mutations, leading to expression of a full length,
functional protein. Investigators have recently shown that members of the aminoglycoside and
macrolide antibiotic families can induce read-through of the nonsense mutations in the APC
gene and lead to reduced oncogenic phenotypes in CRC cells and in different mice models.
The aim of this project is to determine the ability of the macrolide antibiotic-erythromycin
to induce read-through of the nonsense mutations in the APC gene and to induce expression of
a full length, functional APC protein in patients suffering from FAP and to tests its effect
on adenoma number and size and on desmoid tumors in these patients. The future goal is to
maximize the effect of stop-codon suppressors on APC while minimizing side effects.
In this study investigators will select FAP patients which carry APC nonsense mutations,
treat them with erythromycin PO for 4-6 months and examine colonic and duodenal adenomas as
well as abdominal desmoid tumors, that will be documented before during and after treatment.
In parallel, investigators will test polyp, adenoma and desmoid tissue samples as well as
blood samples from these patients for changes in expression levels of the APC protein and
related oncogenic markers.
Suppression of nonsense mutations within the APC gene should be of benefit for patients
suffering from FAP, attenuated FAP or multiple adenomas and for patients with advanced or
diffuse CRC. Furthermore, given the rapid progress being made in the identification of
different nonsense mutations in human genes that lead to mostly un-curable disease, the
identification of clinically approved compounds that suppress nonsense mutations and that
can be administered long-term without significant side effects would open new venues in the
treatment of genetic human diseases that arise from pre-mature stop codons in important
coding sequences.
Immediate goal: establish the ability of erythromycin to read-through APC nonsense mutation
in FAP patients. The read-through effect of erythromycin will be clinically tested by
counting and measuring the number and size of both colonic and duodenal adenomas before and
over treatment and by measuring the size of known desmoid tumors. Samples of the adenomas
and desmoid tumors will be tested by western blot, immunofluorescence and
immunohistochemistry for restoration of APC expression and changes in oncogenic markers.
These experiments should be conducted within 6 month.
Long term objective:
1. Determine the lowest dose of erythromycin that can inhibit growth of colonic neoplasia
and CRC in patients expressing a truncated APC protein due to nonsense mutations.
2. Examine the ability of a panel of additional macrolide antibiotics to induce APC
nonsense mutation suppression using in-vitro methods. Investigators will focus on
macrolide antibiotics that are currently in clinical use and are administrated for long
terms. These objectives should take around 6 month and will be conducted in parallel.
Erythromycin Versus Azithromycin in Preterm Premature Rupture of Membranes [Withdrawn]
Preterm Premature Rupture of Membranes (PPROM) is treated with an antibiotic, erythromycin
or azithromycin, to prolong pregnancy. Erythromycin is taken for several days and can result
in stomach upset in some patients, causing them to stop taking the medication. Therefore,
azithromycin is often prescribed instead. Azithromycin is usually taken only once and
stomach upset is not seen or greatly reduced. The goal of this study is to see if there is a
difference between the antibiotic (azithromycin) compared to the antibiotic (erythromycin)
in prolonging pregnancy in patients with Preterm Premature Rupture of Membranes (PPROM). The
working hypothesis is that there is no difference in the clinical effectiveness between
antibiotic regimens containing the macrolides azithromycin and erythromycin for prolonging
latency in PPROM.
Comparison of Two Macrolides, Azithromycin and Erythromycin, for Symptomatic Treatment of Gastroparesis [Terminated]
Erythromycin is effectively used in the treatment of Gastroparesis (GP) patients. In
susceptible patients however, it has been associated with sudden cardiac death due to
prolongation of QT intervals and subsequent cardiac risks through its interaction some other
drugs. Azithromycin (AZI) is a macrolide antibiotic but does not have the mentioned druf
interactions , has fewer gastrointestinal side effects, and fewer risks of QT prolongation
and cardiac arrhythmias. Consequently, AZI avoids drawbacks of dosing with erythromycin and
may be preferred as a prokinetic agent in patients on other concomitant medications.
We hope to demonstrate the effectiveness of Azithromycin (AZI) as compared to Erythromycin
in the treatment of Gastroparesis (GP), and later, form the framework for larger
randomized-controlled parallel studies to investigate use of AZI for treatment of GP.
Our novel hypothesis is to determine whether AZI can be used to treat GP.
Treatment of Dowling Maera Type of Epidermolysis Bullosa Simplex by Oral Erythromycin [Recruiting]
Dowling Meara type of epidermolysis bullosa simplex (EBS-DM) is a rare genodermatosis due to
keratin 5 and 14 mutation, characterized by skin fragility and spontaneous or post traumatic
blisters. Neonatal period and infancy are critical since this autonomic dominant affection
usually improves with age. Cyclins seem to be efficient in some cases of EBS but are
prohibited in children younger than 8 years old. Erythromycin can be a good alternative in
this population due to its antibacterial and anti-inflammatory potential.
The aim of this study is the evaluation of the efficiency of oral erythromycin to decrease
the number of cutaneous blisters in severe EBS-DM patients from 6 months to 8 years old
after 3 months of treatment.
Primary end point is the number of patients with decrease of blisters' number of at least
20% after 3 months of treatment by oral erythromycin.
It is a preliminary study on 8 patients. Treatment is oral erythromycin twice a day during 3
months. Follow up for each patient is 5 months. The duration of the study is 1 year.
Reports of Suspected Erythromycin Side Effects
Drug Hypersensitivity (62),
Drug Interaction (26),
Rash (21),
Nausea (19),
Toxicity TO Various Agents (19),
Maternal Exposure During Pregnancy (18),
Dyspnoea (17),
Drug Ineffective (16),
Sepsis (15),
Liver Injury (14), more >>
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PATIENT REVIEWS / RATINGS / COMMENTSBased on a total of 7 ratings/reviews, Erythromycin has an overall score of 4.57. The effectiveness score is 5.71 and the side effect score is 5.71. The scores are on ten point scale: 10 - best, 1 - worst. Below are selected reviews: the highest, the median and the lowest rated.
| Erythromycin review by 18 year old female patient | | Rating |
Overall rating: | | |
Effectiveness: | | Moderately Effective |
Side effects: | | Severe Side Effects | | Treatment Info |
Condition / reason: | | Acne on my back |
Dosage & duration: | | 3x daily (dosage frequency: 3x daily) for the period of Still on it |
Other conditions: | | Allergic to milk, |
Other drugs taken: | | Vitamin B-12 | | Reported Results |
Benefits: | | I started noticing changes on my back |
Side effects: | | I started having alot of abdominal pain, and the urge to go to the bathroom, I had a bladder infection. I would also get a headache once in awhile |
Comments: | | I started taking minocycline, although it made me really sick so I then went to this drug |
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| Erythromycin review by 55 year old female patient | | Rating |
Overall rating: | | |
Effectiveness: | | Marginally Effective |
Side effects: | | Mild Side Effects | | Treatment Info |
Condition / reason: | | acne |
Dosage & duration: | | 400mm (dosage frequency: 3 x day) for the period of one year |
Other conditions: | | none |
Other drugs taken: | | none | | Reported Results |
Benefits: | | Treatment was for cystic acne. The dermatologist prescribed erythomyicin for treatment. Saw the dermatologist biweekly and the dermatologist would give me a check over. The dermatologist then would ask if I was doing anything different, and then would proceed to give me a new prescription for the erythromycin. |
Side effects: | | The erthyromycin was prescribed for cystic acne. The erthyromycin is an orally administrated drug for the treatment of bacterial infections. Gastrointestinal disturbances, such as diarrhea, nausea, abdominal pain, and vomiting, are fairly common. Although I did not have any vomiting reactions the other disturbances did occur. The treatment with the erthyromycin did not relieve the cystic acne. I was taking the erythromycin three times a day for almost one year and there were no noticeable results. |
Comments: | | The dermatologist would see me every other week for and check my cystic acne. The medical tech. person would first check me and ask questions regarding any changes in what I was doing and how the medication was working and if there were any side effects. The dermatologist would then come into the room and check my cystic acne. The dermatologist would then ask if I was doing anything different and then would ask if I was taking my medication and ask if I was on any other medications. He wouild ask if there were any bad side effects to the medication and then would give me another prescription for another round of medication treatment. This would go on for about one year of visits and prescriptions. There was not any change in the cystic acne of any great degree. |
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| 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. |
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Page last updated: 2015-08-10
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