I. Mechanism of action

  1. Reversibly binds 50S ribosomal subunit
  2. Inhibits protein synthesis

II. Bacterial resistance Mechanisms

  1. Impermeability of bacterial outer membranes
    1. Especially Gram Negative Organisms
  2. Production of enzymes that alter ribosomal targets

III. Adverse Effects

  1. Gastrointestinal upset
  2. Nausea
  3. Cholestatic Jaundice
  4. Multiple drug interactions

IV. Complications

V. Pharmacokinetics

  1. Half life: 1.5 hours

VI. Drug Interactions

  1. Interactions may also occur with extended spectrum
    1. Clarithromycin
    2. Telithromycin
    3. Less likely to occur with Azithromycin
  2. QT Prolongation (Erythromycin with an agent below)
    1. Calcium Channel Blockers increase Erythromycin level
      1. Verapamil
      2. Diltiazem
    2. Other potent CYP3A4 inhibitors
      1. Ketoconazole
      2. Itraconazole
      3. Nefazodone
      4. Protease Inhibitors
  3. References
    1. Ray (2004) N Engl J Med 351:1089-96 [PubMed] (or open in [QxMD Read])

VII. Oral Preparations (Take with food to reduce GI Upset)

  1. Erythromycin base 1000 mg/day PO divided bid-qid
  2. Erythromycin ethyl succinate (EES)
    1. Adult: 400 mg PO qid
    2. Child: 30-50 mg/kg/day PO divided qid

VIII. Parenteral Preparation: Erythromycin lactobionate

  1. Dose: 15 to 20 mg/kg/day IV divided every 6 hours
  2. Maximum: 4 grams

Images: Related links to external sites (from Google)

Cost: Medications

ERYTHROMYCIN (on 2/10/2012 at Target.com)
ERYTHROMYCIN 5 MG/GM* Ophthalmic Ointment #30 for $4.00 ($0.13/unit)
Erythromycin Ethylsuccinate (on 2/9/2012 at DrugStore.com)
Erythromycin Ethylsuccinate 400mg Tablets #40 for $49.99 ($1.25/unit)
Erythromycin Base (on 2/9/2012 at DrugStore.com)
Erythromycin Base 250mg Enteric Coated Capsule #30 for $64.99 ($2.17/unit)
Erythromycin Base 250mg Tablets #30 for $35.99 ($1.20/unit)
Erythromycin Base 500mg Tablets #30 for $69.99 ($2.33/unit)
Erythromycin (on 2/9/2012 at DrugStore.com)
Erythromycin 5mg/gm Ointment Limited Supply Available. #1 for $25.99 ($25.99/unit)
Erythromycin 2% Solution 60ml Bottle #1 for $49.99 ($49.99/unit)
Erythromycin 2% Gel 30gm Tube #1 for $24.99 ($24.99/unit)
Benzoyl Peroxide-Erythromycin (on 2/9/2012 at DrugStore.com)
Benzoyl Peroxide-Erythromycin 5-3% Gel # for $58.99

Ontology: Erythromycin (C0014806)

Definition (CHV) a kind of antibiotics
Definition (CHV) a kind of antibiotics
Definition (MSH) A bacteriostatic antibiotic macrolide produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins.
Definition (CSP) bacteriostatic antibiotic macrolide produced by Streptomyces erythreus; in sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits; this binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins.
Definition (PDQ) A broad-spectrum, topical macrolide antibiotic with antibacterial activity. Erythromycin diffuses through the bacterial cell membrane and reversibly binds to the 50S subunit of the bacterial ribosome. This prevents bacterial protein synthesis. Erythromycin may be bacteriostatic or bactericidal in action, depending on the concentration of the drug at the site of infection and the susceptibility of the organism involved. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39234&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39234&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C476" NCI Thesaurus)
Definition (NCI) A broad-spectrum, macrolide antibiotic with antibacterial activity. Erythromycin diffuses through the bacterial cell membrane and reversibly binds to the 50S subunit of the bacterial ribosome. This prevents bacterial protein synthesis. Erythromycin may be bacteriostatic or bactericidal in action, depending on the concentration of the drug at the site of infection and the susceptibility of the organism involved.
Concepts Organic Chemical (T109) , Antibiotic(T195)
MSH D004917
SnomedCT 332341008, 30427009, 372694001
English Erythromycin, Erythromycin A, ERYTHROMYCINS, Erythromycin [skin], Erythromycin, NOS, erythromycin base, erythromycin, ERYTHROMYCIN, Erythromycin [skin] (product), erythromycin (medication), 52A ERYTHROMYCINS, Erythromycin Base, Erythromycin [Chemical/Ingredient], erythromycins, Erythromycin product, Erythromycin (product), Erythromycin (substance), Erythromycin [skin] (substance), Erythromycin base, Erythromycins
Swedish Erytromycin
Czech erythromycin
Finnish Erytromysiini
Italian Eritromicina A, Eritromicina
Russian ERITROMITSIN, ЭРИТРОМИЦИН
Spanish eritromicina (uso dermatológico) (producto), eritromicina (uso dermatológico), eritromicina (piel) (producto), eritromicina (piel), eritromicina (producto), eritromicina (sustancia), eritromicina, Eritromicina
Japanese エリスロシン(Erythromycin), エリスリット, タカスノン, エリスロマイシン, アイロタイシン
Croatian ERITROMICIN
Polish Erytromycyna
French Érythromycine
German Erythromycin
Portuguese Eritromicina

Ontology: Macrolides (C0282563)

Definition (MSH) A group of often glycosylated macrocyclic compounds formed by chain extension of multiple PROPIONATES cyclized into a large (typically 12, 14, or 16)-membered lactone. Macrolides belong to the POLYKETIDES class of natural products, and many members exhibit ANTIBIOTIC properties.
Definition (NCI) A term used to describe a chemical structure of a compound containing a large lactone ring, usually with a 14 or 16-membered ring structure. The prototypical compounds within the macrolide class are the erythromycin-based antibiotics; however, many compounds with this chemical structure are being developed for other diseases.
Concepts Organic Chemical (T109) , Pharmacologic Substance(T121)
MSH D018942
SnomedCT 428787002
English Macrolides, Macrolide (substance), Macrolide, Macrolides [Chemical/Ingredient], Macrolide [EPC], Macrolide-class Agent, macrolides, macrolide
Swedish Makrolider
Czech makrolidy
Finnish Makrolidit
Russian MAKROLIDY, МАКРОЛИДЫ
Spanish macrólido, macrólido (sustancia), Macrolidos, Macrólidos
Japanese マクロライド
Polish Makrolidy
Croatian MAKROLIDI
French Macrolides
German Makrolide
Italian Macrolidi
Portuguese Macrolídeos