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Medically reviewed by Oliinyk Elizabeth Ivanovna, PharmD. Last updated on 26.06.2023

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Erithromycin A is a bacteriostatic antibiotic macrolide produced by Streptomyces erythreus. Erithromycin A 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.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Erithromycin Base Filmtab tablets and other antibacterial drugs, Erithromycin Base Filmtab (Erithromycin tablets) 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.
Erithromycin Base Filmtab (Erithromycin tablets) 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 Erithromycin concentrations ordinarily achieved).
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. Erithromycin is effective in eliminating the organism from the nasopharynx of infected individuals, rendering them noninfectious. Some clinical studies suggest that Erithromycin 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. (Erithromycin lactobionate for injection, USP) followed by Erithromycin 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 Erithromycin 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, Erithromycin is indicated for the treatment of uncomplicated urethral, endocervical, or rectal infections in adults due to Chlamydia trachomatis.
Erithromycin injection is used to treat bacterial infections in many different parts of the body. It is also used to treat diphtheria, acute pelvic inflammatory disease, and Legionnaire's disease. Erithromycin is also used to prevent bacterial endocarditis and rheumatic fever to occur again in patients who have had an allergic reaction to penicillin or sulfa drugs.
Erithromycin belongs to the class of medicines known as macrolide antibiotics. It works by killing bacteria or preventing their growth. However, Erithromycin will not work for colds, flu, or other virus infections.
Erithromycin is to be given only by or under the direct supervision of a doctor.
In most patients, PCE tablets are well absorbed and may be dosed orally without regard to meals. However, optimal blood levels are obtained when either PCE 333 mg or PCE 500 mg tablets are given in the fasting state (at least ½ hour and preferably 2 hours before meals).
Adults
The usual dosage of PCE tablets are one 333 mg tablet every 8 hours or one 500 mg tablet every 12 hours. Dosage may be increased up to 4 g per day according to the severity of the infection. However, twice-a-day dosing is not recommended when doses larger than 1 g daily are administered.
Children
Age, weight, and severity of the infection are important factors in determining the proper dosage. The usual dosage is 30 to 50 mg/kg/day, in equally divided doses. For more severe infections this dosage may be doubled but should not exceed 4 g per day.
In the treatment of streptococcal infections of the upper respiratory tract (e.g., tonsillitis or pharyngitis), the therapeutic dosage of Erithromycin should be administered for at least ten days.
The American Heart Association suggests a dosage of 250 mg of Erithromycin orally, twice a day in long-term prophylaxis of streptococcal upper respiratory tract infections for the prevention of recurring attacks of rheumatic fever in patients allergic to penicillin and sulfonamides.
Primary Syphilis
30 to 40 g given in divided doses over a period of 10 to 15 days.
Acute Pelvic Inflammatory Disease Caused by N. gonorrhoeae
500 mg Erythrocin Lactobionate-I.V. (Erithromycin lactobionate for injection, USP) every 6 hours for 3 days, followed by 500 mg of Erithromycin base orally every 12 hours, or 333 mg of Erithromycin base orally every 8 hours for 7 days.
Intestinal Amebiasis
Adults
500 mg every 12 hours, 333 mg every 8 hours or 250 mg every 6 hours for 10 to 14 days.
Children
30 to 50 mg/kg/day in divided doses for 10 to 14 days.
Pertussis
Although optimal dosage and duration have not been established, doses of Erithromycin utilized in reported clinical studies were 40 to 50 mg/kg/day, given in divided doses for 5 to 14 days.
Legionnaires' Disease
Although optimal dosage has not been established, doses utilized in reported clinical data were 1 to 4 g daily in divided doses.
How supplied
PCE tablets (Erithromycin particles in tablets) are supplied as unscored, ovaloid tablets in the following strengths and packages.
333 mg, pink-speckled white (imprinted with PCE):
Bottles of 60
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What is the most important information I should know about Erithromycin?
You should not take Erithromycin if you are allergic to it, or if you are also using cisapride (Propulsid), dihydroergotamine (D.H.E. 45, Migranal), ergotamine (Ergomar, Cafergot, Migergot), or pimozide (Orap). Erithromycin may interact with these medicines and could cause dangerous or life-threatening heart rhythm disorders.
Before you take Erithromycin, tell your doctor if you have liver disease, myasthenia gravis, a heart rhythm disorder, a history of Long QT syndrome, or low levels of potassium or magnesium in your blood.
Take this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Erithromycin will not treat a viral infection such as the common cold or flu.
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking Erithromycin and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.
Use Erithromycin ointment as directed by your doctor. Check the label on the medicine for exact dosing instructions. Check the label on the medicine for exact dosing instructions.
- Erithromycin ointment may be used around the eye or in the eye. To use Erithromycin ointment in the eye, first, wash your hands. Using your index finger, pull the lower eyelid away from your eye to form a pouch. Squeeze a thin strip of ointment into the pouch. After using Erithromycin ointment, gently close your eyes for 1 to 2 minutes. Wash your hands to remove any medicine that may be on them. Wipe the applicator tip with a clean, dry tissue.
- To prevent germs from contaminating your medicine, do not touch the applicator tip to any surface, including the eye. Keep the container tightly closed.
- Erithromycin ointment works best if it is used at the same time each day.
- If more than one infant is being treated, use a new tube for each infant.
- Do not wear contact lenses while you are using Erithromycin ointment. Take care of your contact lenses as directed by the manufacturer. Check with your doctor before you use them.
- To clear up your infection completely, use Erithromycin ointment for the full course of treatment. Keep using it even if you feel better in a few days.
- If you miss a dose of Erithromycin ointment, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.
Ask your health care provider any questions you may have about how to use Erithromycin ointment.
There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.Use: Labeled Indications
Bacterial infections: Treatment of susceptible bacterial infections, including S. pyogenes, some S. pneumoniae, some S. aureus, M. pneumoniae, Legionella pneumophila, diphtheria, pertussis, Chlamydia, erythrasma, N. gonorrhoeae, E. histolytica, syphilis and nongonococcal urethritis, and Campylobacter gastroenteritis; used in conjunction with neomycin for decontaminating the bowel
Surgical (preoperative) prophylaxis (colorectal): Colorectal decontamination, in conjunction with other agents, prior to surgical intervention
Off Label Uses
Acne vulgaris
Based on the American Academy of Dermatology guidelines of care for the management of acne vulgaris, oral Erithromycin, in combination with topical therapy, may be considered as a treatment option for moderate and severe acne and forms of inflammatory acne that are resistant to topical treatments. However, its use should be restricted due to an increased risk of bacterial resistance and limited to patients who cannot receive a tetracycline (ie, pregnant women). Concomitant topical therapy with benzoyl peroxide or a retinoid should be administered with systemic antibiotic therapy (eg, oral Erithromycin) and continued for maintenance after the oral antibiotic course is completed.
Bartonella spp. infections (treatment)
Based on the Infectious Diseases Society of America (IDSA) guidelines for the diagnosis and management of skin and soft tissue infections (SSTI), Erithromycin may be considered for the treatment of cutaneous bacillary angiomatosis. Guidelines state that therapy has not been systematically examined and Erithromycin appears effective based on case reports and small series.
Data from a study with a limited number of patients suggest that Erithromycin may be beneficial for the treatment of Bartonella spp infections.
Gastroparesis (management)
Based on the American College of Gastroenterology (ACG) guidelines for the management of gastroparesis, Erithromycin is effective and recommended for the management of gastroparesis.
Granuloma inguinale (donovanosis)
Based on Centers for Disease Control and Prevention (CDC) sexually transmitted diseases treatment guidelines, Erithromycin (base) is effective and recommended for the treatment of granuloma inguinale when azithromycin is not appropriate.
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What other drugs will affect Erithromycin?
Erithromycin A use in patients who are receiving high doses of theophylline may be associated with an increase in serum theophylline levels and potential theophylline toxicity. In case of theophylline toxicity and/or elevated serum theophylline levels, the dose of theophylline should be reduced while the patient is receiving concomitant Erithromycin therapy.
Concomitant administration of Erithromycin and digoxin has been reported to result in elevated digoxin serum levels. There have been reports of increased anticoagulant effects when Erithromycin and oral anticoagulants were used concomitantly. Increased anticoagulation effects due to interactions of Erithromycin with various oral anticoagulents may be more pronounced in the elderly.
Concurrent use of Erithromycin and ergotamine or dihydroergotamine has been associated in some patients with acute ergot toxicity characterized by severe peripheral vasospasm and dysesthesia.
Erithromycin A has been reported to decrease the clearance of triazolam and midazolam and thus may increase the pharmacologic effect of these benzodiazepines.
The use of Erithromycin in patients concurrently taking drugs metabolized by the cytochrome P450 system may be associated with elevations in serum levels of these other drugs. There have been reports of interactions of Erithromycin with carbamazepine, cyclosporine, tacrolimus, hexobarbital, phenytoin, alfentanil, cisapride, disopyramide, lovastatin, bromocriptine, valproate, terfenadine, and astemizole. Serum concentrations of drugs metabolized by the cytochrome P450 system should be monitored closely in patients concurrently receiving Erithromycin.
Erithromycin A has been reported to significantly alter the metabolism of nonsedating antihistamines terfenadine and astemizole when taken concomitantly. Rare cases of serious cardiovascular adverse events, including electrocardiographic QT/QTc interval prolongation, cardiac arrest, torsades de pointes, and other ventricular arrhythmias have been observed. In addition, deaths have been reported rarely with concomitant administration of terfenadine and Erithromycin.
There have been postmarketing reports of drug interactions when Erithromycin is coadministered with cisapride, resulting in QT prolongation, cardiac arrythmias, ventricular tachycardia, ventricular fibrulation, and torsades de pointes, most like due to inhibition of hepatic metabolism of cisapride by Erithromycin. Fatalities have been reported.
Patients receiving concomitant lovastatin and Erithromycin should be carefully monitored; cases of rhabdomyolysis have been reported in seriously ill patients.
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What are the possible side effects of Erithromycin?
Applies to Erithromycin: oral capsule, oral capsule delayed release, oral powder for suspension, oral suspension, oral tablet, oral tablet chewable, oral tablet delayed release, oral tablet enteric coated
Other dosage forms:
- intravenous powder for solution
As well as its needed effects, Erithromycin (the active ingredient contained in Erithromycin) may cause unwanted side effects that require medical attention.
Major Side Effects
If any of the following side effects occur while taking Erithromycin, check with your doctor immediately:
Rare
- Blistering, peeling, or loosening of the skin
- chills
- cough
- diarrhea
- difficulty with swallowing
- dizziness
- fast heartbeat
- hives or welts
- joint or muscle pain
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- red, irritated eyes
- red skin lesions, often with a purple center
- redness of the skin
- skin rash
- sore throat
- sores, ulcers, or white spots in the mouth or on the lips
- tightness in the chest
- unusual tiredness or weakness
- wheezing
- Abdominal or stomach cramps or tenderness
- bloating
- bloody or cloudy urine
- chest pain or discomfort
- dark urine
- diarrhea, watery and severe, which may also be bloody
- fainting
- fever
- general tiredness and weakness
- greatly decreased frequency of urination or amount of urine
- hearing loss
- increased thirst
- irregular heartbeat recurrent
- irregular or slow heart rate
- light-colored stools
- nausea and vomiting
- pain
- swelling of the feet or lower legs
- unusual weight loss
- upper right abdominal or stomach pain
- yellow eyes and skin
Minor Side Effects
Some Erithromycin side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:
Incidence not known:
- Abdominal or stomach pain
- diarrhea (mild)
- loss of appetite
- weight loss