Today, one of the most effective groups of antibiotics are macrolides, of which Erythromycin is the most prominent representative. This medication has a wide spectrum of antimicrobial effects and exhibits a high level of therapeutic activity in the treatment of a wide range of pathologies of bacterial origin. Due to the fact that improper use of this antibiotic can have a detrimental effect on the state of healthy intestinal microflora, Erythromycin should be used only as prescribed by the attending physician.
Compound
The active ingredient is erythromycin. The content of the active substance in one unit of the drug can be 100 mg, 250 mg and 500 mg.
The enteric coating contains the following components:
- medical castor oil;
- titanium dioxide;
- cellulose acetylphthalyl.
Auxiliary components:
- polyphenylpyrrolidone;
- polysorbate 80;
- talc;
- potato starch;
- calcium stearate;
- Kollidon CL-M.
Erythromycin tablets are packaged in blisters of 10 units and then placed in cardboard packages of 1 or 2 pieces. An exception is the dosage form containing erythromycin 500 mg. Such tablets are packaged in cardboard boxes of 2 or 4 blisters.
Pharmacodynamics
The drug Erythromycin belongs to the macrolide group of antimicrobial agents. It has a pronounced bacteriostatic effect, which consists in significantly slowing down or completely stopping microbial reproduction. The active substance forms a reversible bond with the large subunit of 50S ribosomes, which prevents the formation of peptide bonds between amino acids and disrupts the protein synthesis of microorganisms. In the case of taking increased dosages of the substance erythromycin, the drug begins to exhibit a pronounced bactericidal effect, which leads to the death of pathological microflora with its subsequent removal from the body. Does not affect the formation of nucleic acids.
The spectrum of therapeutic effects includes: gram-negative and gram-positive microbes, bacteria that produce and do not produce penicillinase, alpha hemolytic streptococcus and a number of other sensitive microorganisms. Based on the degree of susceptibility to erythromycin, the following types of bacteria are distinguished:
- sensitive (erythromycin concentration not less than 0.5 mg/l);
- moderately sensitive (1–5 mg/l);
- moderately resistant or resistant (6–8 mg/l).
Drug interactions of Erythromycin
The antibiotic reduces the bactericidal effect of beta-lactam antimicrobial drugs - cephalosporins, penicillins, carbopenems.
Erythromycin enhances the nephrotoxicity of cyclosporine and the pharmacological effect of benzodiazepines.
The simultaneous use of Erythromycin and terfenadine or astemizole contributes to the possible development of arrhythmia.
Simultaneous administration of the drug and dihydroergotamine or non-hydrogenated ergot alkaloids leads to spasmodic vasoconstriction.
Pharmacokinetics
The antibiotic drug Erythromycin has a high level of absorption capacity. Enteric tablets do not lose their therapeutic properties when taken with food. The maximum concentration of the substance in the blood is reached 2.5–4 hours after the initial oral administration. The ability to bind to blood plasma proteins averages 80%.
Biological availability – 35 – 60%. When a large amount of the drug is ingested, the substance erythromycin tends to accumulate in the kidneys, liver and spleen. It has the ability to penetrate the pleural cavity, middle ear exudate, sperm, synovial and ascitic fluid, lymph nodes and prostate secretions. Moreover, the concentration of erythromycin in urine and bile is several times higher than the content in blood plasma. The substance can also pass into breast milk. Exit through the blood-brain barrier into the spinal cord fluid is insignificant (approximately 10% of the total concentration in blood plasma). In case of development of inflammatory lesions, the penetrating effect of erythromycin increases. Can penetrate into the fetal blood through the placental barrier (5-20% of the concentration in the maternal blood plasma).
Metabolism takes place 90% in the liver with partial production of inactive metabolites. Excretion occurs with bile. Also, a small part of the substance is excreted through the kidneys.
Indications for use
The therapeutic use of the drug Erythromycin is justified in the treatment of the following infectious diseases of a bacterial nature:
- brucellosis;
- diphtheria;
- scarlet fever;
- infectious lesions of soft tissues and skin;
- gonorrhea;
- whooping cough (can be used as a means to prevent this disease);
- chronic trachoma;
- conjunctivitis in newborns;
- legionellosis (legionnaires' disease);
- cholecystitis;
- chronic bacterial dermatosis (erythrasma);
- listeriosis;
- infectious pathologies of the lower and upper respiratory tract;
- childhood pneumonia;
- syphilis in the primary form (Erythromycin is used if the patient is allergic to penicillin antibiotics);
- amoebiasis;
- chlamydia without complications (in case of ineffectiveness or intolerance of tetracyclines);
- infectious pathologies of the genitourinary system in pregnant women;
- tonsillitis, sinusitis, otitis media;
- infectious lesions of the mucous membrane of the eye;
Erythromycin is also used as a means of preventing the following cases:
- stages of exacerbation of streptococcal infection in patients with rheumatism (pharyngitis or tonsillitis);
- infectious lesions during diagnostic and surgical procedures (dental interventions, preparatory procedures before intestinal operations, endoscopic diagnosis for existing heart defects).
Contraindications for use
Due to the high activity of the active component of the drug Erythromycin, there are a number of contraindications to the therapeutic use of this drug:
- hypersensitivity or complete intolerance to the components of the medication;
- breastfeeding period;
- loss or limitation of auditory perception;
- simultaneous use of erythromycin with astemizole or terfenadine.
You should also be careful in the following conditions:
- renal or liver failure;
- jaundice;
- arrhythmia;
- long QT syndrome.
Method of therapeutic use
For adult patients, a single dose of Erythromycin is 250–500 mg. In this case, the permissible therapeutic maximum consumption of the drug is 1000–2000 mg. In the case of severe forms of infectious pathologies, the amount of the substance can be increased to 4000 mg per day. An interval of six hours must be maintained between doses.
For children from 4 months to 18 years, the daily intake is calculated using the formula 30–50 mg per kilogram of the child’s weight. In the first 3 months, the permitted dose is 20–40 mg per kilogram of weight per day. If necessary, this amount can be doubled by the doctor.
To treat legionellosis, you need to take 500–1000 mg of Erythromycin 4 times a day. The duration of the course is 2 weeks.
When treating amoebic dysentery in adults, the medication should be 250 mg 4 times a day. For children - an average of 40 mg per kilogram of weight. Duration of use – 2 weeks.
In the first 3 days during treatment for gonorrhea, you need to drink 500 mg of Erythromycin every 6 hours. Further, the amount of the drug is reduced to 250 mg. The course of treatment is 1 week.
When treating diphtheria infection carriage, you need to take the drug 2 times a day, 250 mg.
Treatment of whooping cough is accompanied by daily intake of Erythromycin in the amount of 40–50 mg per kilogram of the child’s weight. The duration of therapy is from 5 to 14 days. For pneumonia, this amount increases to 50–60 mg. The course of treatment is 10 days.
In case of development of infectious diseases of the genitourinary system in pregnant women, it is necessary to take 500 mg of the medicine 4 times a day for a week.
Erythromycin ointment for nasal sores
Erythromycin ointment helps cleanse wound surfaces from pathogenic microorganisms that are sensitive to it. The drug is used for empyema of the paranasal sinuses, as well as microtraumas of its mucous membranes - scratches, abrasions, chemical burns. After applying the ointment, the bacteria die, the inflammatory process weakens, and the pain disappears. Single and daily doses of the drug depend on the severity of symptoms. Treating a sore in the nose with Erythromycin ointment is simple:
- rinse affected mucous membranes and dry;
- if necessary, remove any crusts that have formed;
- Apply a thin layer of Erythromycin ointment, covering some healthy tissue.
The medicine is also used in other ways for pain. You should soak gauze turundas with it and insert them into the nasal passages for an hour. The drug is used up to 3 times a day. The last application should be before bedtime, since recovery processes are most active at night. The duration of the therapeutic course should not exceed three weeks. Otherwise, such treatment will cause active growth and reproduction of opportunistic fungi and the development of mycoses.
Side effects
The use of Erythromycin must be agreed with the attending physician due to the risk of a number of side effects. The main reactions to the use of the drug Erythromycin are:
- nausea and vomiting;
- abdominal pain;
- intestinal disorder;
- dysbacteriosis;
- oral candidiasis;
- liver dysfunction;
- pancreatitis;
- deterioration of auditory perception;
- pseudomembranous colitis;
- skin allergic manifestations.
Rarely:
- ventricular arrhythmia;
- tachycardia;
- prolongation of the QT interval;
- anaphylactic shock.
Overdose, signs of side effects on the body
If incorrect doses of medication are used, hearing loss and disturbances in the functioning of the liver and kidneys (acute failure) are possible. To eliminate the consequences of an overdose, gastric lavage is used. Hearing acuity usually returns after discontinuation of the drug.
The medical literature describes cases of side effects when using an antibiotic, including:
- disruptions in the gastrointestinal tract (gastralgia, attacks of nausea, diarrhea, vomiting);
- cholestatic jaundice;
- allergic reactions;
- pancreatitis.
In addition, Erythromycin has side effects that disrupt the normal state of internal microbiocenosis.
Most often, these kinds of negative effects are manifested by the occurrence of dysbacteriosis and candidiasis of the oral mucosa.
- Erythromycin: drug analogues;
- Read here - Macrolides: drugs, list of names and indications;
- Amoxicillin or azithromycin: which is better: https://med-antibiotiks.com/vopros-otvet/amoksicilin-i-azitromicin-chto-luchshe-i-pri-kakix-zabolevaniyax/.
Analogs
Instead of Erythromycin, the following drugs can be used:
- Sumamed contains azithromycin as an active component, which is characterized by a wide spectrum of action. The antibiotic is produced in capsules, dispersing or coated tablets, powder for preparing a suspension, lyophilisate from which a solution for intravenous infusion is prepared. It can be prescribed from birth, and it can be prescribed to pregnant women.
- Klacid is a substitute for Erythromycin in the clinical and pharmacological group. In the pharmacy, the drug is found in tablets, powder for the preparation of a suspension for oral administration, and lyophilisate for the preparation of an infusion solution. The antibiotic can be used in children from birth; its use during pregnancy and breastfeeding is contraindicated.
- Macropen belongs to the Erythromycin substitutes in the therapeutic group. The active component of the drug is midecamycin. The antibiotic is commercially available in granules, from which a suspension is made for oral administration and in tablets. In liquid form, the drug can be given to children from birth. Pregnant patients may be treated with antibiotics.
- Rulid contains roxithromycin as an active ingredient. The antibacterial agent is available in tablets, approved for patients over 12 years of age and weighing more than 40 kg. It is prohibited from being prescribed to patients who are pregnant or breastfeeding.
Erythromycin ointment - description and action
Erythromycin in ointment form is an external agent with an antibacterial effect. The main active substance is a macrolide antibiotic with a wide spectrum of activity - erythromycin
(there are 10,000 units of it in the product).
The drug also contains a number of auxiliary components:
- sodium disulfate;
- petrolatum;
- sodium pyrosulfite;
- lanolin anhydrous.
The product is available in tubes of 5 g (eye ointment) and 10.15 g, which are packaged in cardboard boxes. It is produced by various pharmaceutical companies, “Sintez”, “Tathimfarmpreparaty”, the average price of the largest package is 150 rubles
.
The drug is non-toxic and can be used on any part of the body or face. It is tolerated by patients better than drugs based on penicillin antibiotics. Erythromycin has an antimicrobial effect - it binds to the ribosomal components of bacteria, destroys the molecular bonds of amino acids, thereby inhibiting the synthesis of microbial proteins. Erythromycin helps against diseases caused by microbes sensitive to it:
- neisseria;
- chlamydia;
- staphylococcus;
- streptococcus;
- influenza;
- bordetella;
- Brucella;
- corynebacterium;
- clostridia.
A number of gram-negative bacilli do not respond to treatment due to resistance to the active substance (Escherichia coli, Shigella, Pseudomonas aeruginosa).
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