Rhythm

Susceptible infections, Respiratory tract infections, Enteritis, Pertussis, Trench fever, Chanroid, Chlamydial infections, Diphtheria, Legionnaire's disease, Pneumonia, Sinusitis, Bronchitis, Acne, Rheumatic fever, Neonatal conjunctivitis.

Should be taken on an empty stomach. Best taken on an empty stomach at least ½ hr & preferably 2 hr before meals. Reconstitution: Oral susp: Add 77 mL of water and shake vigorously. This makes 100 mL susp.

Adults: Usually 250 mg every 6 hours, or 500 mg every 12 hours. May increase up to 4 g/day, according to severity of infection. Upper respiratory tract infections of mild to moderate severity: 250 to 500 mg 4 times a day for 10 days. Lower respiratory infections of mild to moderate severity: 250 to 500 mg 4 times a day for 10 days. Respiratory tract infections due to Mycoplasma pneumoniae: 500 mg 6 hours for 5 to 10 days, treat severe infections for up to 3 weeks. Skin and soft tissue infections of mild to moderate severity: 250 to 500 mg 4 times a day for 10 days. Pelvic inflammatory diseases (PID), acute due to Neisseria gonorrhoeae: 500 mg 4 times a day for 10 to 14 days. Urogenital infection during pregnancy caused by Chlamydia trachomatis: 500 mg 4 times daily for 7 days or 250 mg 4 times daily for 14 days. Urethral, endocervical or rectal infections, uncomplicated: 500 mg 4 times daily for 7 days or 250 mg 4 times daily for 14 days. Non-gonococcal urethritis: 500 mg 4 times daily for at least 7 days. Neisseria gonorrhoeae: Uncomplicated urethral, endocervical or rectal infections and in penicillinase producing N. gonorrhoeae(PPNG): 500 mg 4 times a day for 7 days. Early syphillis (primary, secondary or latent syphillis of < 1 year duration): 500 mg 4 times a day for 14 days. Severe or chronic diarrhoea: 500 mg 4 times a day for 7 days. Rheumatic fever: 250 mg 2 times daily. Bacterial endocarditis: 1 g 2 hours prior to procedures, then 500 mg 6 hours after initial dose. Acne: 500 mg twice daily for 3 months reduced to 250 mg twice for 3 months. Hepatic Impairment Use caution

Children: PO 50 mg/kg/day q6–8h

Renal Impairment Dose adjustment not necessary

Hypersensitivity; porphyria; hepatic impairment; pregnancy.

Erythromycin inhibits protein synthesis by irreversibly binding to the 50S ribosomal subunit thus blocking the transpeptidation or translocation reactions of susceptible organisms resulting in stunted cell growth.

Increased risk of cholestatic hepatitis when treatment is >10 days or in patients with previous history of erythromycin usage. History of hepatic disorders; arrhythmias; prolonged QT interval; lactation. Monitor liver function. Avoid estolate in liver impairment. Caution when using lactobionate in patients with severe renal impairment. May aggravate muscle weakness in patients with myasthenia gravis. Lactation: distributed in breast milk, use with caution; AAP categorizes as compatible with breastfeeding

1-10% Abdominal pain (8%),Headache (8%),Nausea (8%),Diarrhea (7%),Rash (3%),Vomiting (3%),Dyspepsia (2%),Flatulence (2%),Pain (2%),Pruritus (1%),Pseudomembranous colitis Hypertrophic pyloric stenosis,Anaphylaxis,Fever,Mild allergic reactions,Urticaria,Skin eruptions,Tinnitus <1% Cholestatic hepatitis,Confusion,Hallucinations,Hearing loss,Hypotension,Nervous system effects including seizures,Torsade de pointes,Ventricular tachycardia,Vertigo Potentially Fatal: Hepatotoxicity, cholestatic jaundice; raised serum transaminases; eosinophilia.

Pregnancy category: B Lactation: Drug enters breast milk; use with caution (American Academy of Pediatrics committee states that drug is compatible with nursing)

May decrease plasma levels of valproic acid thus, increasing the risk of seizures. Increased plasma concentrations w/ probenecid.