03/04/2009 19:53


Brand Name: Akne-mycin, A/T/S, Apo-Erythro (CAN), Diomycin (CAN), E-Mycin, Erybid (CAN), ERYC, EryDerm, Erygel, Erymax, Ery-Tab, Erythra-Derm, Erythromid (CAN), Erythromycin Film-tabs, Ilotycin, Novo-Rythro (CAN), PCE (CAN), PCE Dispertab, Staticin

Pregnancy Category B

Drug class: Macrolide antibiotic


Therapeutic actions

Bacteriostatic or bactericidal in susceptible bacteria; binds to cell membrane, causing change in protein function, leading to cell death.


· Acute infections caused by sensitive strains of Streptococcus pneumoniae, Mycoplasma pneumoniae, Listeria monocytogenes, Legionella pneumophila

· URIs, LRIs, skin and soft-tissue infections caused by group A beta-hemolytic streptococci when oral treatment is preferred to injectable benzathine penicillin

· PID caused by N. gonorrhoeae in patients allergic to penicillin

· In conjunction with sulfonamides in URIs caused by Haemophilus influenzae

· As an adjunct to antitoxin in infections caused by Corynebacterium diphtheriae and Corynebacterium minutissimum

· Prophylaxis against alpha-hemolytic streptococcal endocarditis before dental or other procedures in patients allergic to penicillin who have valvular heart disease



Systemic administration

· Contraindicated with allergy to erythromycin.

Ophthalmic ointment

· Contraindicated with allergy to erythromycin; viral, fungal, mycobacterial infections of the eye.



Adverse effects

Systemic administration

Reversible hearing loss, confusion, uncontrollable emotions, abnormal thinking

Abdominal cramping, anorexia, diarrhea, vomiting, pseudomembranous colitis, hepatotoxicity

Allergic reactions ranging from rash to anaphylaxis


· Increased serum levels of digoxin

· Increased effects of oral anticoagulants, theophyllines, carbamazepine, ergot derivatives, disopyramide, calcium blockers, fluoroquinolones, HMG CoA reductase inhibitors, proton pump inhibitors

· Increased therapeutic and toxic effects of corticosteroids

· Increased levels of cyclosporine and risk of renal toxicity


· Decreased metabolism and increased risk of toxic effects if taken with grapefruit juice; avoid this combination


Nursing considerations

Systemic administration

· Culture site of infection before therapy.

· Administer oral erythromycin base or stearate on an empty stomach, 1 hr before or 2–3 hr after meals, with a full glass of water (oral erythromycin estolate, ethylsuccinate, and certain enteric-coated tablets [see manufacturer's instructions] may be given without regard to meals).

· Administer around the clock to maximize effect; adjust schedule to minimize sleep disruption.

· Monitor liver function in patients on prolonged therapy.

· Give some preparations (see above) with meals, or substitute one of these preparations, if GI upset occurs with oral therapy.

Topical dermatologic solution for acne

· Wash affected area, rinse well, and dry before application.

Ophthalmic and topical dermatologic preparation

· Use topical products only when needed. Sensitization produced by the topical use of an antibiotic may preclude its later systemic use in serious infections. Topical antibiotic preparations not normally used systemically are best.

· Culture site before beginning therapy.

· Cover the affected area with a sterile bandage if needed (topical).