Erythromycin

Erythromycin – the antibiotic of group of macroleads synthesized by strains of bacteria of Streptomyces erythreus.

Ilozon, Ermitsed, Gryunamitsin syrup, Meromitsin, Eriflyuid, Eritromen, Erythranum – drugs-substitutes (analogs) of Eritromitsin.

Structure and form of release

According to the instruction Erythromycin is produced in the form of tablets (100, 250 and 500 mg); in the form of an oculentum; in the form of ointment for topical and external use; in the form of lyophilisate for preparation of solution for intravenous injections. Substance erythromycin – the main operating drug component.

Pharmacological effect of Erythromycin

Erythromycin and analogs of Erythromycin break process of formation of bonds between amino-acid molecules, blocking protein synthesis of bacteria (do not exert impact on process of formation of nucleic acids). Use of Erythromycin in high doses promotes manifestation of its bactericidal effect.

According to the instruction treatment by Erythromycin or analogs of Erythromycin is appointed at the diseases caused gram-negative (Haemophilus influenzae, Neisseria gonorrhoeae, Brucella spp., Bordetella pertussis, Legionella spp) or gram-positive bacteria (Streptococcus spp., Staphylococcus spp., synthesizing and not synthesizing a penicillinase, an alpha and hemolitic streptococcus from the group Viridansa, Corynebacterium minutissimum, Corynebacterium diphtheriae, Bacillus anthracis), and also Listeria monocytogenes, Treponema spp., Chlamydia spp., Entamoeba histolytica, Rickettsia spp.

Rezistentna to Eritromitsin gram-negative sticks of Pseudomonas aeruginosa, Escherichia coli, and also Salmonella spp., Shigella spp.

Microorganisms which growth is slowed down at concentration of drug less than 0.005 g/l, sensitive in average degree – from 0,001 to 0,006 g/l, moderately steady and steady – from 0,006 to 0,008 g/l are considered sensitive to Erythromycin.

In an organism Erythromycin is distributed unevenly. Its most part collects in kidneys, a spleen, a liver. Drug well gets into synovial and ascitic liquids, a pleural cavity, into tissues of lungs, sperm. Concentration in cerebrospinal fluid makes 10% of the maintenance of an antibiotic in plasma.

In a liver the main part of Erythromycin (about 90%) is metabolized. With bile 20-30% of an antibiotic, by kidneys - 2-5% of Erythromycin in an invariable look are removed (an elimination half-life – 1,5-2 hours).

Indications to Erythromycin use

According to the instruction treatment by Erythromycin is shown at various infectious and inflammatory processes, including at respiratory infections, diphtheria, prostatitis, scarlet fever, amoebic dysentery, listeriosis, syphilis, cholecystitis, gonorrhea. Erythromycin is applied in treatment of infections of soft tissues and skin - trophic ulcers, burns of the second and third degree, furunculosis, contaminated wounds, pustulous diseases of skin. Besides, the antibiotic is applied at various infections of a mucous membrane of eyes (including at conjunctivitis at newborns), at urinogenital infections at the pregnant women called by Chlamydia trachomatis.

In responses to Erythromycin it is specified that this antibiotic is quite often applied to prevention of infectious complications at various diagnostic and medical procedures.

The instruction to use

According to the instruction Erythromycin in tablets should accept be (not to chewed) inside. The daily dose of drug for adults and teenagers (14 years are more senior) makes 1-2 g, one-time – 0,25-0,50. If necessary daily the dose is increased to 4 g. An interval between receptions – six hours.

To children from four months to 18 years, depending on the body weight, age and disease severity appoint 0,03 - 0,05 g/kg a day in two-four receptions, to children of the first three months of life – 0,2-0,4 g/kg of Erythromycin a day. If necessary the daily dose is doubled.

At treatment by Erythromycin of diphtheria accept 0,25 g of drug two times a day.

Therapeutic dose at primary syphilis - 30-40 g of an antibiotic on all course of treatment. A course of treatment – one-two weeks.

At amoebic dysentery the adult appoint 0,25 g of drug four times a day, to children - on 0.03-0,05 g/kg of Erythromycin a day. Course duration - 10-15 days.

At legionellosis accept 0,5-1 medicines four times a day within two weeks.

At gonorrhea - on 0,5 g of drug each six hours within three days, further - on 0,25 g each six hours within a week.

For prevention of infectious complications appoint on 1 g of an antibiotic in 19 hours, 18 hours and 9 hours prior to operation.

At whooping cough accept 0,04-0,05 g/kg of an antibiotic a day within one-two weeks. At pneumonia at children – 0,05 g/kg of an antibiotic a day (in four receptions). Course duration – not less than three weeks.

At urinogenital infections during pregnancy – 0,5g a medicine four times a day within a week.

Erythromycin in the form of ointment is applied on the struck area, and at eye diseases put for a lower eyelid. Frequency, a dose and duration of use of Erythromycin in the form of ointment are established individually.

Contraindications to Erythromycin use

• hypersensitivity to any component of drug;
• lactation period;
• hearing loss;
• concomitant use of an astemizol or terfenadin;
• liver failure.

Erythromycin is capable to get through a placental barrier, coming to a fruit blood plasma where its concentration reaches 5-20% of concentration in mother's blood.

Side effect

Side effects at treatment by Erythromycin arise infrequently. In responses to Erythromycin it is said that at prolonged use of an antibiotic there is vomiting, a diarrhea, nausea, jaundice.

Judging by responses, Erythromycin in some cases can cause allergic reactions.

Prolonged use of Erythromycin promotes development of resistance to it pathogenic microorganisms.

Overdose

Overdose symptoms Erythromycin: acute liver failure, hearing loss.

Therapy: reception of absorbent carbon, careful observation of a condition of system of breath. The gastric lavage is considered effective at reception of the dose fivefold exceeding a medical dose.

Medicinal interaction of Erythromycin

The antibiotic reduces bactericidal effect beta лактамных antimicrobic drugs – cephalosporins, penicillin, a karbopenema.

Erythromycin increases nephrotoxicity of cyclosporine and pharmacological effect of benzodiazepines.

One-time reception of Erythromycin and terfenadin or astemizol promotes possible development of arrhythmia.

One-time administration of drug and dihydroergotamine or not hydrogenated alkaloids of an ergot leads to spasmodic vasoconstriction.

Term and storage conditions

According to the instruction Erythromycin should be stored in the dry, protected from light place, at a temperature not above 25 °C.

Period of storage – two years.