What Are the Most Common Uses for Erythromycin Tablets?

Erythromycin tablets, the indications are 1. This product is an alternative medicine for patients with penicillin allergies to treat the following infections: acute tonsillitis, acute pharyngitis, sinusitis caused by hemolytic streptococcus, pneumococcus, etc .; scarlet fever, cellulitis caused by hemolytic streptococcus; diphtheria and Diphtheria carriers; gas gangrene, anthrax, tetanus; actinomycosis; syphilis; listeriosis, etc. 2. Legionella. 3 Mycoplasma pneumoniae pneumonia. 4 Chlamydia pneumoniae pneumonia. 5. Urinary and genital infections caused by other Chlamydia and Mycoplasma species. 6. Chlamydia trachomatis conjunctivitis. 7. Neisseria gonorrhoeae infection. 8. Oral infections caused by anaerobic bacteria. 9. Campylobacter jejuni enteritis. 10 pertussis. 11. Recurrence of rheumatic fever, infective endocarditis (rheumatic heart disease, congenital heart disease, post-valvular heart valve replacement), preventive medication for oral and upper respiratory tract medical procedures (alternative medication for penicillin).

Drug Name: Erythromycin tablets

Drug type: Prescription medicines, essential medicines, medicines for medical workers' injuries
Use classification: Antibiotics

Erythromycin Tablet Properties

This product is an enteric-coated tablet, which appears white or off-white after removing the coating.

Erythromycin tablets indications

1. This product is an alternative medicine for patients with penicillin allergies to treat the following infections: acute tonsillitis, acute pharyngitis, sinusitis caused by hemolytic streptococcus, pneumococcus, etc .; scarlet fever, cellulitis caused by hemolytic streptococcus; diphtheria and Diphtheria carriers; gas gangrene, anthrax, tetanus; actinomycosis; syphilis; listeriosis, etc.
2. Legionella.
3 Mycoplasma pneumoniae pneumonia.
4 Chlamydia pneumoniae pneumonia.
5. Urinary and genital infections caused by other Chlamydia and Mycoplasma species.
6. Chlamydia trachomatis conjunctivitis.
7. Neisseria gonorrhoeae infection.
8. Oral infections caused by anaerobic bacteria.
9. Campylobacter jejuni enteritis.
10 pertussis.
11. Recurrence of rheumatic fever, infective endocarditis (rheumatic heart disease, congenital heart disease, post-valvular heart valve replacement), preventive medication for oral and upper respiratory tract medical procedures (alternative medication for penicillin).

Erythromycin tablet specifications

(1) 0.125g (125,000 units)
(2) 0.25g (250,000 units)

Erythromycin tablets usage dosage

Orally, 0.75 to 2 g a day for adults, 3 to 4 times a day, and children 3 to 4 times a day for 20 to 40 mg / kg of body weight.
For the treatment of Legionnaires' disease, adults 0.5 ~ 1.0g once a day, 4 times a day.
When used as a medicine for the prevention of rheumatic fever recurrence, it is 0.25g once, twice a day.
When used as a preventive drug for infective endocarditis, take 1 g orally 1 hour before surgery and 0.5 g 6 hours after surgery.

Erythromycin tablets adverse reactions

1. Gastrointestinal reactions are common, including diarrhea, nausea, vomiting, upper and middle abdominal pain, mouth and tongue pain, and decreased gastric appetite.
2. Hepatotoxicity is rare, and patients may have fatigue, nausea, vomiting, abdominal pain, fever and abnormal liver function, and occasionally jaundice.
3 High-dose (4g / day) application, especially patients with liver and kidney disease or elderly patients, may cause hearing loss, which is mainly related to excessive blood concentration (> 12mg / L), and most of them can be recovered after discontinuation.
4 Allergic reactions are manifested as drug fever, rash, and eosinophilia. The incidence is about 0.5% to 1%.
5. Other: occasional arrhythmia, oral or vaginal candidiasis.

Erythromycin tablets contraindications

Those who are allergic to erythromycin drugs are prohibited.

Precautions for erythromycin tablets

1. Hemolytic streptococcal infection should be treated with this product for at least 10 days to prevent the occurrence of acute rheumatic fever.
2. Patients with renal impairment generally do not need to reduce the dosage.
3 In order to obtain a higher blood concentration, erythromycin should be taken on an empty stomach (1 hour before or 3 to 4 hours after a meal) with water.
4 Routine follow-up of liver function during medication. The dose of erythromycin in patients with liver disease and severe renal impairment should be appropriately reduced.
5. When patients are allergic or intolerant to one erythromycin preparation, they may also be allergic or intolerant to other erythromycin preparations.
6. Interference to diagnosis: This product can interfere with the fluorescence measurement of the Higerty method, which makes the measured value of urinary catecholamines falsely increase. Measurements of serum alkaline phosphatase, bilirubin, alanine aminotransferase, and aspartate aminotransferase may all increase.
7. Due to the differences in the sensitivity of different bacteria to erythromycin, a drug sensitivity test should be performed.

Erythromycin tablets for pregnant and lactating women

1. This product can enter the fetal circulation through the placenta, the concentration is not high, there are no reports on the impact of the fetus in the literature, but pregnant women should still weigh the pros and cons when using it.
2. A considerable amount of this product enters breast milk. Breastfeeding women should suspend breastfeeding when applied.

Erythromycin tablets drug interactions

1. This product can inhibit the metabolism of antiepileptic drugs such as carbamazepine and valproic acid, resulting in an increase in its blood concentration and toxic reactions. This product combined with alfentanil can inhibit the metabolism of the latter and prolong its action time. This product combined with antihistamines such as astemizole or terfenadine can increase cardiotoxicity, and combined with cyclosporine can increase the blood concentration of the latter and produce nephrotoxicity.
2. It has antagonism with chloramphenicol and lincosamide, and it is not recommended to be used together.
3 This product is a bacteriostatic agent, which can interfere with the bactericidal efficacy of penicillin. Therefore, when rapid bactericidal effects such as meningitis are needed, the two should not be used at the same time.
4 Long-term use of warfarin in patients with this product can lead to prolonged prothrombin time, thereby increasing the risk of bleeding, especially in elderly patients. When the two must be used together, the dose of warfarin should be adjusted appropriately, and the prothrombin time should be closely observed.
5. In addition to dihydroxyprophylline, the combination of this product with xanthines can reduce the liver clearance of aminophylline, leading to an increase in serum aminophylline concentration and / or an increase in toxic reactions. This phenomenon is more likely to occur after 6 days of combined use, and the reduction of aminophylline clearance is proportional to the serum peak of this product. Therefore, the dose of xanthines should be adjusted during and after the combined treatment.
6. Co-administration with other liver-toxic drugs may enhance liver toxicity.
7. High-dose erythromycin is used in combination with ototoxic drugs, especially in patients with impaired renal function, which may increase ototoxicity.
8. When combined with lovastatin, it can inhibit its metabolism and increase blood concentration, which may cause rhabdomyolysis. When combined with midazolam or triazolam, it can reduce the clearance of both and enhance its effect.

Erythromycin tablets overdose

The drug should be stopped promptly and symptomatic and supportive treatment should be given. Blood or peritoneum is rarely eliminated after dialysis.

Erythromycin tablets pharmacology and toxicology

Erythromycin is a macrolide antibiotic and has antibacterial activity against Staphylococcus, streptococci and gram-positive bacilli. Neisseria, Haemophilus influenzae, and Bordetella pertussis can also be sensitive to this product. This product also has antibacterial activity against various anaerobic bacteria other than B. fragile and Clostridium; it also has inhibitory effects on Legionella, Campylobacter fetus, certain Borrelia, Mycoplasma pneumoniae, Rickettsia and Chlamydia . This strain is a bacteriostatic agent, but it also has a bactericidal effect on some bacteria at high concentrations. This product can penetrate the bacterial cell membrane and reversibly bind to the 50S subunit of the bacterial ribosome near the donor site ("P" position), blocking the binding of transfer ribonucleic acid (t-RNA) to the "P" position. At the same time, the displacement of the polypeptide chain from the accepting position ("A" position) to the "P" position is also blocked, so bacterial protein synthesis is inhibited. Erythromycin is only effective against actively dividing bacteria. This product is low toxicity. Acute toxicity test in mice, oral lethal dose (LD ₅₀ ) was 2.93 to 3.11 g / kg; rats in oral administration were> 3 g / kg.

Erythromycin tablets pharmacokinetics

After oral administration of erythromycin alkali enteric-coated tablets on a fasting 250 mg, the blood concentration reached a peak within 3 to 4 hours, with an average of about 0.3 mg / L. Except for cerebrospinal fluid and brain tissue after absorption, it is widely distributed in various tissues and body fluids, especially the highest concentration in liver, bile and spleen. The concentration in kidney, lung and other tissues can be several times higher than the concentration of bleeding drug, and in bile The concentration can reach 10 to 40 times the blood concentration. Concentrations in subcutaneous tissue, sputum and bronchial secretions are also high. The concentration in sputum is similar to that in blood; the concentration in pleural, ascites, pus, etc. can reach effective levels. A certain amount of this product (about 33% of blood concentration) enters the prostate and seminal vesicles, but it is not easy to penetrate the blood-brain barrier. When the meninges are inflamed, the concentration in the cerebrospinal fluid is only about 10% of the blood concentration. It can enter fetal blood and be excreted into breast milk. The fetal blood drug concentration is 5% to 20% of the maternal blood drug concentration, and the drug concentration in breast milk can reach more than 50% of the blood drug concentration. The apparent distribution volume (V _d ) is 0.9 L / kg. The protein binding rate is 70% to 90%. Free erythromycin is metabolized in the liver, and the blood elimination half-life (t _{1 / 2} ) is 1.4 to 2 hours. The t _{1 / 2 of} patients with anuria can be extended to 4.8 to 6 hours. Erythromycin is mainly concentrated in the liver and excreted from the bile, and undergoes enterohepatic circulation. About 2% to 5% of the oral amount and 10% to 15% of the injection amount are excluded from the glomerular filtration, and the urine concentration can reach 10 100mg / L, a certain amount is also contained in feces. It is rarely removed after hemodialysis or peritoneal dialysis, so there is no need to add it after dialysis.