Erythromycin

Erythromycin is an antibiotic that belongs to the group of macrolides. Here is a brief characteristic of this drug:

• Mechanism of action: Erythromycin is a bacteriostatic antibiotic, which inhibits protein synthesis in the bacterial cell by preventing the binding of transport RNA to ribosomes. This leads to impaired protein synthesis and inhibits bacterial growth and reproduction.
• Spectrum of action: The drug has a broad spectrum of antimicrobial action and is effective against many Gram-positive and Gram-negative bacteria, as well as some other microorganisms.
• Indications for use: The drug is used to treat various infections, including respiratory tract infections (such as bronchitis, pneumonia, sinusitis), skin and soft tissue infections, urogenital infections, syphilis and others.
• Forms of release: Erythromycin is available in various forms: in the form of tablets, capsules, powder for suspension preparation, as well as in the form of solution for intramuscular or intravenous injection.
• Side Effects: Like any other antibiotic, Erythromycin can cause various side effects including diarrhea, nausea, vomiting, animal pain, allergic reactions, etc.
• Contraindications: The use of the drug may be contraindicated in case of allergy to the drug, as well as in the presence of certain conditions, such as severe hepatic insufficiency.

It is important to use the drug only as prescribed by your doctor and follow his instructions to maximize the effectiveness of treatment and minimize the risk of side effects.

Indications Erythromycin

1. Respiratory tract infections: Erythromycin may be prescribed to treat acute and chronic forms of bronchitis, pneumonia, sinusitis, pharyngitis, laryngitis and other respiratory tract infections.
2. Skin and soft tissue infections: The drug is widely used to treat a variety of skin and soft tissue infections, including boils, abscesses, cellulitis, wounds, and others.
3. Syphilis: The drug may be used to treat syphilis, especially in cases of intolerance to penicillins.
4. Urogenital infections: The drug may be effective in treating urogenital infections such as urethritis, cervicitis and others.
5. Other Infections: Erythromycin may also be used to treat gonorrhea, diphtheria, legionellosis, brucellosis and other infections caused by susceptible microorganisms.
6. Prophylaxis: The drug can be used to prevent a number of infections such as diphtheria, rheumatic fever and others.

Release form

1. Tablets and capsules: The drug is often supplied as tablets or capsules for oral (by mouth) administration. Tablets and capsules may have different dosages, such as 250 mg, 500 mg, or 1000 mg.
2. Powder for preparing a suspension: Erythromycin may also be supplied as a powder that needs to be dissolved to make a suspension. This is usually used for children or patients who have difficulty swallowing tablets.
3. Solution for injection: In some cases, erythromycin may be presented as a solution for injection. This form of release may be used to treat serious infections or in cases where oral administration is ineffective.
4. Creams and ointments: Erythromycin may be part of topical preparations in the form of creams or ointments that are applied directly to the skin to treat infections.
5. EyeOintments: Erythromycin may be used in eye ointments to treat eye infections or prophylaxis after eye surgery.

Pharmacodynamics

Erythromycin is an antibiotic from the macrolide class that is used to treat various infections caused by bacteria such as Streptococcus, Staphylococcus, Haemophilus influenzae, Mycoplasma pneumoniae, Legionella pneumophila, etc.

The mechanism of action of erythromycin is based on its ability to bind to bacterial ribosomes (specifically to the 50S subunit) and inhibit protein synthesis. This leads to disruption of the translation (protein synthesis) process in the bacterial cell. As a result, the bacterial cell is unable to synthesize new proteins necessary for its growth and reproduction, which ultimately leads to bacterial death or suppression of bacterial growth and reproduction.

In addition, the drug has a bacteriostatic effect, which means that it can slow the growth of bacteria without even killing them directly. This gives the body's immune system time to kill the bacteria.

Pharmacokinetics

1. Absorption: Erythromycin is usually taken orally in the form of tablets or syrup. It is rapidly and completely absorbed from the gastrointestinal tract.
2. Distribution: The drug is well distributed in the body, including the respiratory tract, soft tissues and skin. It also penetrates the placental barrier and is excreted in breast milk.
3. Metabolism: Erythromycin is metabolized in the liver. The main metabolite is N-demethylerythromycin, which also has antimicrobial activity.
4. Excretion: Approximately 2-5% of the drug dose is excreted through the kidneys in unchanged form, the rest is excreted through bile in the intestine.
5. Concentration: Maximum plasma concentrations of erythromycin are usually reached 1-2 hours after oral administration.
6. Duration of action: The effect of the drug lasts about 6-12 hours, depending on the dose and frequency of administration.
7. Interactions with other drugs: Erythromycin may interact with other drugs, including drugs metabolized in the liver and those that increase the QT-interval, which may lead to cardiac arrhythmias.

Dosing and administration

1. Tablets or capsules:

   • Usually taken orally (orally) before or with meals.
   • The dosage is usually 250 mg to 500 mg every 6 hours or 12 hours, depending on your doctor's recommendations.
   • The duration of treatment is determined by the doctor depending on the severity of the infection, usually treatment lasts from 5 to 14 days.

2. Suspension:

   • For children or adults who have difficulty swallowing tablets or capsules, Erythromycin may be given as a suspension.
   • Dosage usually depends on the weight and age of the patient and may be given in milligrams per kilogram of weight or according to age.
   • The suspension should be shaken before each use and then the correct amount should be measured using the measuring syringe or spoon provided.

3. Solution for injection:

   • Erythromycin Injections are usually given in a medical facility under the supervision of medical personnel.
   • The dosage and frequency of injections depend on the type of infection, severity of the condition, and other factors, and will be determined by your doctor.

Use Erythromycin during pregnancy

Erythromycin is considered relatively safe for use during pregnancy, especially if the benefits outweigh the potential risks. However, the following points should be taken into account:

1. Risk-benefit assessment: Before prescribing erythromycin during pregnancy, the doctor should assess the potential risks to the mother and fetus and compare them with the expected benefits of treatment.
2. Phase of pregnancy: The use of the drug may be safer in the second and third trimesters of pregnancy compared to the first trimester, when the fetal organs are actively forming.
3. Dosage and duration: The doctor should determine the optimal dosage and duration of treatment depending on the type of infection and the general condition of the patient.
4. Alternatives: In some cases, it may be possible to use alternative antibiotics that have a broader clinical experience of use in pregnancy.

Contraindications

1. Hypersensitivity: Patients with known hypersensitivity to erythromycin or other macrolide antibiotics should not take this drug because of the risk of allergic reactions.
2. Hypersensitivity to other antibiotics: Because antibiotics from different classes may have structural similarities, patients with known hypersensitivity to other antibiotics such as azithromycin or clarithromycin may also have contraindications to the drug.
3. QT interval prolongation: Erythromycin may prolong the QT interval on ECG (electrocardiography), which may be dangerous in patients with heart rhythm disorders or when used concomitantly with other drugs prolonging the QT interval. Therefore, it should be used with caution in patients with cardiovascular disease or those taking other drugs that affect the heart rhythm.
4. Myasthenia gravis: The drug may exacerbate symptoms of myasthenia gravis, an autoimmune disorder resulting in decreased muscle tone, therefore its use may be contraindicated in patients with this condition.
5. Hepatic insufficiency: In the presence of severe hepatic insufficiency the use of erythromycin should be avoided due to the possibility of accumulation of the drug and its metabolites in the body.
6. Administration of terfenadine or astemizole: The drug may increase the concentration of terfenadine and astemizole in the blood, which may lead to the development of arrhythmias. Therefore, concomitant use of these drugs may be contraindicated.
7. Pregnancy and breastfeeding: The use of erythromycin during pregnancy and breastfeeding may require special attention and doctor's advice, especially in the first trimester of pregnancy.

Side effects Erythromycin

1. Gastrointestinal Disorders: The most common side effects include diarrhea, nausea, vomiting, abdominal discomfort, appetite disturbances, and dyspepsia (stomach upset).
2. Allergic Reactions: Some patients may develop allergic reactions to erythromycin, including skin rash, itching, hives, and even anaphylaxis (severe allergic reaction).
3. Gutdysbiosis: The use of antibiotics, including erythromycin, can upset the balance of microflora in the gut, which can lead to the development of dysbiosis and candidiasis.
4. Cardiac rhythm disturbances: The drug may cause cardiac rhythm disturbances such as QT interval prolongation on ECG, especially in people with cardiac disorders or when co-administered with other drugs that prolong the QT interval.
5. Blood changes: In rare cases, blood changes such as anemia, thrombocytopenia, and leukopenia may occur.
6. Other rare side effects: Other side effects including headache, dizziness, drowsiness, insomnia, paresthesias, increased liver enzyme activity, etc. May also occur.

Overdose

1. Severe stomach upset: Nausea, vomiting, diarrhea, and abdominal pain may be the most common symptoms.
2. Heart rhythm disorders: Erythromycin can cause QT prolongation, which can lead to cardiac arrhythmias such as atrial fibrillation, tachycardia, and even potentially dangerous cardiac arrhythmias.
3. Allergic Reactions: Allergic reactions including hives, itching, swelling, angioedema or even anaphylactic shock may occur.
4. Other systemic manifestations: May include dizziness, headache, drowsiness, loss of consciousness, respiratory disturbances and even respiratory arrest.

Interactions with other drugs

1. Drugs metabolized in the liver: Erythromycin is an inhibitor of cytochrome P450 isoenzymes, which may slow down the metabolism of other drugs metabolized in the liver. This may lead to an increase in their concentration in the blood and an increased risk of toxic effects.
2. Drugs that increase QT-interval: The drug may increase the duration of QT-interval on ECG. Combined use with other drugs that also prolong the QT-interval, such as antiarrhythmic drugs (e.g. Amidarone, sotalol), antidepressants (e.g. Citalopram, fluoxetine) or antibiotics (e.g. Fluoroquinolones), may increase the risk of cardiac arrhythmias, including severe and life-threatening ones.
3. Drugs that increase hepatotoxicity: Erythromycin may increase the hepatotoxicity of other drugs such as triazolam, simvastatin, cyclosporine and others, which may lead to increased liver enzyme levels and liver damage.
4. Drugs that reduce the effectiveness of contraception: The drug may reduce the effectiveness of oral contraceptives, which may lead to an increased risk of unwanted pregnancy.
5. Drugs that increase gastric juice secretion: Erythromycin may increase the absorption of other orally administered drugs due to increased gastric juice secretion.

Storage conditions

1. Temperature: Erythromycin should be stored at room temperature, usually 15 to 30 degrees Celsius (59 to 86 degrees Fahrenheit).
2. Humidity: The drug should be stored in a dry place to avoid decomposition or aggregation.
3. Light: The drug should be stored in a light-protected place to prevent exposure to direct sunlight or other light sources that may affect its stability.
4. Packaging: The drug should be stored in its original packaging or container to minimize the impact of external factors on its quality.
5. Additional recommendations: It is important to follow the instructions on the product package regarding storage conditions. Some manufacturers may provide additional recommendations depending on the specifics of the product.