In this article, you can read the instructions for use of the drug. Erythromycin. Presented reviews of visitors to the site – the consumers of this medicine, as well as the opinions of doctors of specialists on the use of Erythromycin in their practice. A big request to add your feedback on the drug more actively: the medicine helped or did not help to get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogs of Erythromycin in the presence of available structural analogues. Use for the treatment of angina, acne (acne) in adults, children, as well as during pregnancy and lactation.
Erythromycin – bacteriostatic antibiotic from the group of macrolides reversibly binds to the 50S subunit of ribosomes in its donor part, which disrupts the formation of peptide bonds between amino acid molecules and blocks the synthesis of proteins of microorganisms (does not affect the synthesis of nucleic acids). When used in high doses, it can show a bactericidal effect.
The spectrum of action includes gram-positive and gram-negative microorganisms, as well as other microorganisms: Mycoplasma spp. (at
Steady gram-negative bacilli: Escherichia coli, Pseudomonas aeruginosa, as well as Shigella spp., Salmonella spp. other. The sensitive group includes microorganisms whose growth is delayed when the antibiotic concentration is less than
Absorption is high. Eating does not affect the oral form of erythromycin in the form of the base, covered with an enteric coating.
In the body is distributed unevenly. In large quantities accumulates in the liver, spleen, kidneys. In bile and urine, the concentration is ten times higher than the concentration in plasma. It penetrates well into the tissues of the lungs, lymph nodes, exudate of the middle ear, the secret of the prostate gland, semen, pleural cavity, ascitic and synovial fluids. Milk in lactating women contains 50% of the plasma concentration. It penetrates poorly through the blood-brain barrier into the cerebrospinal fluid (its concentration is 10% of the content of the drug in plasma). In inflammatory processes in the lining of the brain, their permeability to erythromycin increases slightly. Penetrates through the placental barrier and enters the fetal blood, where its content reaches 5-20% of the content in the mother’s plasma.
Removal with bile – 20-30% unchanged, the kidneys (unchanged) after ingestion – 2-5%.
Bacterial infections caused by sensitive microflora:
- diphtheria (in
Forms of release
Tablets, coated, soluble in the intestines of 100 mg, 250 mg and 500 mg.
Ointment for topical and external use (sometimes mistakenly called gel).
Lyophilisate for preparation of solution for intravenous administration (in vials for injection).
Instructions for use and dosage
A single dose for adults and adolescents over 14 years old is 250-500 mg, daily – 1-2 g. Interval between doses – 6 hours. For severe infections, the daily dose may be increased to 4 g.
Children from 4 months to 18 years, depending on the age, body weight and severity of the infection – at 30-50 mg / kg per day in 2-4 doses; children of the first 3 months life – 20-40 mg / kg per day. In case of more severe infections, the dose may be doubled.
For the treatment of diphtheria carriage – 250 mg 2 times a day. The course dose for the treatment of primary syphilis is 30-40 g, the duration of treatment is 10-15 days.
In adults with amebic dysentery, 250 mg 4 times a day, children 30-50 mg / kg per day; course duration – 10-14 days.
When legionellosis – 500 mg-1 g 4 times a day for 14 days.
For gonorrhea, 500 mg every 6 hours for 3 days, then 250 mg every 6 hours for 7 days.
For preoperative preparation of the intestine to prevent infectious complications – by mouth, 1 g for 19 hours, 18 hours and 9 hours before the start of the operation (3 g in total).
For the prevention of streptococcal infection (with tonsillitis, pharyngitis) adults – 20-50 mg / kg per day, children – 20-30 mg / kg per day, the course duration – at least 10 days.
For the prevention of septic endocarditis in patients with heart defects, 1 g for adults and 20 mg / kg for children, 1 hour before the treatment or diagnostic procedure, then 500 mg for adults and 10 mg / kg for children, again after 6 hours
With whooping cough – 40-50 mg / kg per day for 5-14 days. With pneumonia in children – 50 mg / kg per day in 4 divided doses, for at least 3 weeks. For urinary infections during pregnancy – 500 mg 4 times a day for at least 7 days or (if this dose is poorly tolerated) – 250 mg 4 times a day for at least 14 days.
In adults, with uncomplicated chlamydia and intolerance of tetracyclines – 500 mg 4 times a day for at least 7 days.
Set individually depending on the location and severity of the infection, the sensitivity of the pathogen. In adults, use in a daily dose of 1-4 g. Children under the age of 3 months – 20-40 mg / kg per day; at the age of 4 months to 18 years – 30-50 mg / kg per day. Frequency of use – 4 times a day. The course of treatment is 5-14 days, after the symptoms disappear, the treatment is continued for another 2 days. Take 1 hour before meals or 2-3 hours after meals.
Solution for external use lubricates the affected skin.
Ointment is applied to the affected area, and in case of eye diseases, it is laid behind the lower eyelid. The dose, frequency and duration of use is determined individually.
- skin allergies (urticaria, other forms of rash);
- anaphylactic shock;
- nausea, vomiting;
- abdominal pains;
- oral candidiasis;
- pseudomembranous enterocolitis (both during and after treatment);
- hearing loss and / or tinnitus (when using high doses – more than 4 g /, hearing loss after drug withdrawal is usually reversible);
- prolongation of the QT interval on the ECG;
- ventricular arrhythmias, including ventricular tachycardia (such as "pirouette") in patients with prolonged QT interval.
- hearing loss;
- concomitant use of terfenadine or astemizole;
- lactation period.
Use during pregnancy and lactation
In connection with the possibility of penetration into breast milk, you should refrain from breastfeeding while taking erythromycin.
With long-term therapy, it is necessary to monitor the laboratory parameters of liver function.
Symptoms of cholestatic jaundice may develop several days after the start of therapy, but the risk of development increases after 7-14 days of continuous therapy. The likelihood of ototoxic effect is higher in patients with renal and hepatic insufficiency, as well as in elderly patients.
Some resistant strains of Haemophilus influenzae are sensitive to the simultaneous administration of erythromycin and sulfonamides.
May interfere with the determination of catecholamines in the urine and the activity of hepatic transaminases in the blood (colorimetric determination using definilhydrazine).
Incompatible with lincomycin, clindamycin and chloramphenicol (antagonism).
Reduces the bactericidal effect of beta-lactam antibiotics (penicillins, cephalosporins, carbopenems).
When taken concurrently with drugs metabolized in the liver (theophylline, carbamazepine, valproic acid, hexobarbital, phenytoin, alfentanil, disopyramide, lovastatin, bromocriptine), the concentration of these drugs in the plasma can increase (it is an inhibitor of microsomal liver enzymes).
Enhances the nephrotoxicity of cyclosporine (especially in patients with concomitant renal failure). Reduces clearance of triazolam and midazolam, and therefore may enhance the pharmacological effects of benzodiazepines.
When taken simultaneously with terfenadine or astemizole – the possibility of arrhythmia, with dihydroergotamine or non-hydrated ergot alkaloids – vasoconstriction to spasm, dysesthesia.
Slows down the elimination (enhances the effect) of methylprednisolone, felodipine and coumarin anticoagulants.
When taken together with lovastatin, rhabdomyolysis increases.
Increases digoxin bioavailability.
Reduces the effectiveness of hormonal contraception.
Analogs of the drug Erythromycin
Structural analogues of the active substance:
- Groynamycin syrup;
- Erythromycin Phosphate;