Erythromycin (Eryc): A Drug’ Review

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Brand name and generic equivalents

Erythromycin (Eryc) is a drug belonging to a class of antibiotics called macrolide antibiotics. It is got from saccharopolyspora erythraea (Herrell 14).

It is a chemical base that forms salts when mixed with acids.

There are various brand names for erythromycin with some including E-Mycin, E.E.S. Granules etc.

Generic derivatives of this drug include Azithromycin, Clarithromycin, Roxithromycin, Cethromycin, Telithromycin etc (Webb & Smith 22).

Source, class and common usage

Erythromycin is capable of stopping bacterial growth by hindering bacterial protein synthesis.

It is commonly used as tablets, capsules, oral suspensions, injections, topical ointments and gels.

Clinical Pharmacokinetics

Erythromycin usually “diffuses directly into tissues and phagocytes” (Herrell 17).

Due to high concentration of the drug in phagocyte cells, it is mediated through active transport to infected cells. Eventually, the drug is eliminated through active phagocytosis (Chorghade 16).

According to Herrell, (2009) Medical Encyclopedia, “Erythromycin is metabolized in the liver through demethylation and eliminated through the bile fluid”.

Indications and Usage

It is used to treat various bacterial infections of the skin and respiratory tract.

For topical use, the affected area is first washed thoroughly, rinsed with warm water, patted dry and drug applied once or twice a day while for oral or injection use the drug is taken as per the doctor’s prescription (Herrell 25).

Erythromycins are also used in the treatment off listeriosis, whooping cough, syphilis, diphtheria, erythrasma, chlamydia, acute pelvic inflammatory disease and pneumonia.

It may also be used in the prevention of both initial and recurrent attacks of rheumatic fever.

Contraindications

Erythromycin has been contraindicated in patients that have shown signs of hypersensitivity to the drug.

It has also been reported that the drug alters the metabolism of various drugs when taken concomitantly and as such patients taking them should take precautions or seek assistance from a doctor.

Examples of drugs altered by erythromycin are terfenadine, astemizole, cisapride, quinidine, theophylline, digoxin, benzodiazepines, and some oral anticoagulants (Webb & Smith 34). Others may include ergotamine, triazolam, midazolam and drugs metabolized by the cytochrome P450 system.

Warnings

Precautions should be taken when administering the drug especially with giving it to patients with hepatic dysfunction, myasthenia gravis (muscle disorder), lactating mothers and the elderly. The drug should only be used in presence of bacterial infection and prolonged or repeated use should be avoided as this may lead to overgrowth of nonsusceptible bacteria or fungi (Chorghade 23).

Side effects to erythromycin are mostly of gastrointestinal types but dermatological ones may also occur.

The gastrointestinal side effects occur due to oral administration of the drug and may include the following symptoms: vomiting, nausea, lack of appetite, mild heartburn, abdominal pains, and diarrhea.

Anorexia, prolonged QT syndrome in geriatric patients, hepatic dysfunction, rhabdomyolysis and pseudo membranous colitis may also occur (Herrell 40).

It is important for the patient to share his/her medical history and allergies if any with the doctor before the drug is given.

Drug Abuse and Dependence

There is no evidence indicating that prolonged use of erythromycin causes addiction.

However prolonged or repeated use may cause bacterial growth and in this case the medication should be stopped.

Incase a patient overdoses, the unabsorbed drug must be removed immediately.

Adverse Reactions

Allergic reactions to the medication are rare but may include rashes, swelling of the facial features, nausea and vomiting.

Life threatening reactions may include severe dizziness, fainting, breathing and hearing problems, seizures, irregular heartbeats and intestinal infection (Webb & Smith 47).

The drug may be used be used on an empty stomach one to two hours before or after a meal.

Dosage

Dosage usually depends on the patient’s age and weight and the degree of infection.

For children; the usual dosage is 30 to 50mg/kg/day while for adults; the usual dosage is 250mg every six hours.

Incase the drug is to be taken twice a day; the recommended dosage is 500mg every 12 hours.

However, the dosage may be increased depending on the degree or severity of infection.

How Supplied

Erythromycin is supplied in big containers of 75,000 (NDC 50546-300-01) as white and orange colored capsules.

Each capsule imprinted Eryc WC 696 contains 250mg of erythromycin. The drug should be kept at controlled room temperatures of between 15 and 30 degrees centigrade (between 59 and 86 degrees fare height) i.e. it should be refrigerated and not frozen (Chorghade 35).

The container’s lid should be tightly closed. The drug should be kept away from children’s reach.

Works Cited

Chorghade, Mukund S. Drug Discovery and Development, Volumes 1-2. New Jersey: John Wiley and Sons, 2006.

Herrell, Wallace E. Erythromycin, Issue 1; Issue. New York: Medical Encyclopedia, 2009.

Webb, Michael L. & Smith, Richard J. Analysis of Drug Impurities. Oxford: Wiley- Blackwell, 2007.

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