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At least 721 records · Page 40Linked to original sources
PubMed1993

Ototoxicity of erythromycin in man: electrophysiologic approach.

Ototoxicity is probably the least acknowledged adverse reaction of erythromycin. The mechanism of erythromycin ototoxicity is still unknown. Here we report on two new cases of erythromycin-induced hearing loss. In both of them, serial evoked auditory brainstem potentials (EABPs) were obtained. The recorded EABPs showed absence of waves I to III during treatment with erythromycin, and normalization of all EABP waves after the administration of erythromycin had been stopped. Our findings support the hypothesis that erythromycin-induced hearing loss is attributable to a functional disorder in the peripheral parts of the auditory system.

Aged↗
PubMed1996

Effectiveness of erythromycin in the treatment of acute bronchitis.

BACKGROUND: Clinical trials have not shown a consistent benefit of treating bronchitis with antibiotics. Many physicians, however, treat acute bronchitis with antibiotics because of the possibility of Mycoplasma pneumoniae or other pathogens. The objectives of this study were to determine the effectiveness of erythromycin treatment in patients with acute bronchitis and to determine whether a newly developed rapid M pneumoniae antibody test is useful in predicting which patients will respond to therapy. METHODS: We conducted a randomized, double-blind, placebo-controlled clinical trial at three primary care centers in North Carolina. A convenience sample of 140 patients presenting with acute bronchitis were tested for M pneumoniae, 91 of whom were treated with either erythromycin 250 mg four times daily for 10 days or an identical-appearing placebo. RESULTS: Patients treated with erythromycin missed an average of only 0.81 +/- 1.1 days of work compared with 2.16 +/- 3.2 days for placebo-treated patients (P < .02). There were no significant differences in cough, use of cough medicine, general feeling of well-being, or chest congestion between the erythromycin and placebo groups. Twenty-five percent of the patients tested positive for M pneumoniae. There were no differences in response to erythromycin based on whether the patient had a positive test for M pneumoniae. CONCLUSIONS: Erythromycin is effective in significantly reducing lost time from work, but it is not effective in reducing cough or other symptoms in patients with acute bronchitis, regardless of the outcome of the M pneumoniae antibody test.

Acute Disease↗
PubMed1996

Effect of bethanechol or erythromycin on gastric emptying in horses.

OBJECTIVE: To investigate the prokinetic effect of bethanechol and erythromycin in the upper gastrointestinal tract of healthy horses by measuring the gastric emptying (GE) rate of a radioactive meal. ANIMALS: 4 healthy adult horses. PROCEDURE: After food was withheld for 12 hours, horses were given 370 MBq of 99mTc-labeled sulfur colloid incorporated into egg albumen and 37 MBq of 111In-labeled diethyltriaminepentaacetic acid in 120 ml of water via nasogastric intubation. Intravenously administered treatments were 0.9% NaCl solution, erythromycin (0.1 or 1.0 mg/kg of body weight), or bethanechol (0.25 mg/kg). All drugs were given in 10 ml of 0.9% NaCl solution. Dual-phase scintigraphic images were obtained by use of a gamma camera. The best-fit function was determined for each study, and the resultant curves were then analyzed by use of least squares nonlinear regression. Two variables, time to 50% emptying of the stomach (T-50) and slope of the emptying curve, were derived from the calculated power exponential equation. CONCLUSIONS: Treatment had a significant (P < 0.05) overall effect on T-50 of solid-phase GE. The T-50 of bethanechol (30.09 +/- 10.01 minutes), erythromycin at 0.1 mg/kg (59.08 +/- 10.01 minutes), and erythromycin at 1 mg/kg (60.50 +/- 10.01 minutes) were significantly shorter than T-50 after saline administration (89.97 +/- 10.01 minutes). There was a trend (P = 0.09) for the slope of solid-phase GE of bethanechol and erythromycin (0.1 mg/ kg; P = 0.37) to be steeper than that of saline solution. For liquid-phase GE, the T-50 and the slope of bethanechol differed significantly (P < or = 0.05) from those for saline solution. CLINICAL RELEVANCE: Bethanechol and erythromycin significantly increased solid-phase GE in healthy horses and may have value for use as prokinetic agents in certain gastrointestinal tract diseases.

Animals↗
PubMed1996

[Erythromycin-induced hearing loss in a patient with Listeria monocytogenes meningo-ventriculitis].

We report a 43-year-old woman who suffered from Listeria monocytogenes meningitis. She was admitted to our hospital because of headache, nausea, vomiting, and fever. On admission she had no abnormal neurological signs except for severe nuchal stiffness. Cerebrospinal fluid (CSF) examination on the day of admission revealed pleocytosis and increased total protein level. The CSF culture demonstrated Listeria monocytogenes. Because ampicillin therapy was not effective, erythromycin (8 g/day) was added. After 12 hours of erythromycin therapy, the patient complained of moderate hearing difficulty. Erythromycin was then stopped on the next day. Her hearing improved and became normal within 48 hours after discontinuation of erythromycin. Contrast MRI of the brain revealed enhancement of the ependyma of the lateral ventricle, suggesting the presence of ventriculitis. By parenteral administration of ampicillin and cephazolin, clinical symptoms improved quickly, and abnormal CSF and MRI findings were normalized. Listeria meningitis accompanied with ventriculitis has been reported in neonates and infants, but not in adults. In addition, this is the first case with erythromycin-induced hearing loss in the Japanese literature. Hearing should be regularly examined in patients who are treated with high-dose erythromycin (> or = 4 g/day), and the drug should be immediately discontinued when the patient develops hearing loss.

Adult↗
PubMedDate not supplied

[Activity of erythromycin and clarithromicin against isolates of Streptococcus pneumoniae with decreased sensitivity to penicillin obtained from healty carriers. Spanish Collaborative Group].

BACKGROUND: Empirical treatment of pneumococcal upper and lower respiratory infections must be chosen on the basis of the susceptibility patterns of nasopharyngeal colonizing strains isolated from healthy carriers. METHODS: The susceptibility to erythromycin and clarithromycin was investigated by a conventional microdilution method among 103 pneumococci isolates recovered from healthy children (n = 63) and adults (n = 40) exhibiting decreased susceptibility to penicillin (MIC > or = 0.12 mg/l). RESULTS: 63% of penicillin -resistant pediatric isolates were susceptible to erythromycin and 78.9% were susceptible to clarithromycin . Among isolates with diminished susceptibility to penicillin , 77.7% were susceptible to erythromycin and 86.3% to clarithromycin . 90% of adult isolates were susceptible to erythromycin and to clarithromycin . Overall, clarithromycin exhibited a better activity than erythromycin . CONCLUSIONS: Clarithromycin , and to a lesser extent erythromycin , are good alternatives to penicillin in the empirical treatment of respiratory tract infections caused by pneumococci with diminished susceptibility to penicillin .

Adolescent↗
PubMed1997

[Effects of erythromycin on H2O2 generation by neutrophils].

Low-dose long-term erythromycin therapy has been reported to be effective in diffuse panbronchiolitis, but the mode of action remains obscure. We therefore evaluated the effect of erythromycin the generation of H2O2 by neutrophils. In vitro, erythromycin (0.1, 1.0, and 20 micrograms/ml) suppressed both spontaneous and PMA-stimulated H2O2 generation. H2O2 generation by neutrophils obtained from peripheral blood and from bronchoalveolar lavage fluid from patients with diffuse panbronchiolitis was higher than that from healthy controls. After erythromycin therapy, H2O2 generation by neutrophils was lower. Compared with the control, H2O2 generation by peripheral neutrophils was low in the patients who responded clinically to erythromycin therapy, but was high in those who did not respond. These results suggest that at least some of the therapeutic effect of erythromycin in patients with diffuse panbronchiolitis is due to reduction in H2O2 generation by neutrophils.

Anti-Bacterial Agents↗
PubMed1976

[Studies on erythromycin stearate capsules (OE-7) (author's transl)].

The blood concentration and urinary excretion of OE-7 (erythromycin stearate capsules) and control drug were investigated in 6 volunteers having gastroptosis. OE-7, newly arranged capsules containing erythromycin stearate, was investigated and obtained the results of high blood concentration by oral administration. To confirm the above, we measured blood concentration and urinary excretion of OE-7 comparing with ordinary erythromycin stearate capsules in 6 volunteers having gastroptosis. The peaks of blood concentration were noted at 3 hours after administration in 6 volunteers uniformly. The mean maximum blood concentration of OE-7 was 1.17 mcg/ml which was significantly higher than ordinary erythromycin stearate capsules. In time course of mean blood concentration, the blood concentration levels of OE-7 were higher than those of control erythromycin stearate capsules at any measurement. Effective blood levels were continuously high in OE-7. Urinary excretion of OE-7 reached to the maximum from 4 to 6 hours after administration which was also higher than control erythromycin stearate. Clinical efficacy of OE-7 was investigated in 28 cases in acute respiratory infection. The results noted were excellent in 5 cases (17.9%), good in 16 cases (57.1%), no change in 6 cases (21.4%), and undetermined in 1 case (3.6%). There were 5 cases of slight gastro-intestinal discomfort as the side effects. As the conclusion, OE-7 revealed good bioavailability and seemed to be useful antibiotic for acute respiratory infections.

Adult↗
PubMed1998

Comparative studies of in vitro inhibition of cytochrome P450 3A4-dependent testosterone 6beta-hydroxylation by roxithromycin and its metabolites, troleandomycin, and erythromycin.

Roxithromycin has been shown to be a relatively weak inhibitor of cytochrome P450 (P450 or CYP)-dependent drug oxidations, compared with troleandomycin. The potential for roxithromycin and its major metabolites found in human urine [namely the decladinosyl derivative (M1), O-dealkyl derivative (M2), and N-demethyl derivative (M3)] to inhibit testosterone 6beta-hydroxylation after metabolic activation by CYP3A4 was examined and compared with inhibition by troleandomycin and erythromycin in vitro. Of roxithromycin and its studied metabolites, M3 was the most potent in inhibiting CYP3A4-dependent testosterone 6beta-hydroxylation by human liver microsomes and was activated to the inhibitory P450.Fe2+-metabolite complex to the greatest extent. Roxithromycin and its metabolites were N-demethylated by human liver microsomes, although the rates were slower than those measured with troleandomycin and erythromycin as substrates. Recombinant human CYP3A4 in a baculovirus system coexpressing NADPH-P450 reductase was very active in catalyzing the N-demethylation of roxithromycin, M1, and M2, as well as troleandomycin, erythromycin, and M3. The order for inhibition of CYP3A4-dependent testosterone 6beta-hydroxylation activities by these macrolide antibiotics in the recombinant CYP3A4 system was estimated to be troleandomycin > erythromycin >/= M3 >/= M2 > M1 >/= roxithromycin. Erythromycin, roxithromycin, and its metabolites all failed to inhibit CYP1A2-dependent (R)-warfarin 7-hydroxylation and CYP2C9-dependent (S)-warfarin 7-hydroxylation but did inhibit CYP3A4-dependent (R)-warfarin 7-hydroxylation. These results suggest that roxithromycin itself is not as potent an inhibitor of CYP3A4 activities as are troleandomycin and erythromycin, probably because of the slower metabolism of this compound to metabolites M1, M2, and M3 in humans.

Anti-Bacterial Agents↗
PubMed1998

Comparative Study of the Effects of Erythromycin and Roxithromycin on Action Potential Duration and Potassium Currents in Canine Purkinje Fibers and Rabbit Myocardium.

BACKGROUND: Erythromycin and roxithromycin are macrolide antibiotics in common clinical use. Erythromycin occasionally produces life-threatening arrhythmias (torsades de pointes) by blocking the outward potassium current responsible for repolarization of the cardiac action potential. METHODS AND RESULTS: We used standard cellular electrophysiological and whole-cell patch-clamping techniques to compare the relative efficacy of erythromycin and roxithromycin in prolonging cardiac action potential in canine Purkinje fibers and in blocking individual outward potassium currents in isolated rabbit ventricular myocytes. We demonstrated significant prolongation of action potential duration in canine Purkinje fibers by erythromycin but not roxithromycin at a concentration of 100 µM. The delayed rectifier, the outward potassium current thought to be most sensitive to modulation by drugs, was significantly depressed by both agents at concentrations of >/=30 µM in isolated rabbit ventricular myocytes. Both drugs had similar potencies (26% and 21% reduction by 30 µM erythromycin and roxithromycin, respectively, and 50% and 36% reduction by 100 µM erythromycin and roxithromycin). Neither agent significantly blocked other potassium currents (including the transient outward current). CONCLUSIONS: Taking into account normally observed peak blood concentrations of these agents in clinical use and the fact that roxithromycin is not normally administered intravenously, we conclude that the risk of proarrhythmia during normal clinical use of oral roxithromycin is extremely remote.

Journal Article↗
PubMed1986

Early treatment with erythromycin of Campylobacter jejuni-associated dysentery in children.

To evaluate the efficacy of early treatment with erythromycin on the duration of fecal excretion and of diarrhea associated with Campylobacter jejuni, 170 patients, age 3 to 60 months, were randomly assigned in a double-blind fashion to receive either erythromycin ethyl succinate or placebo immediately after being seen at Cayetano Heredia Hospital because of acute dysentery. The groups' pretreatment characteristics were comparable. Of the 30 patients with stools positive for C. jejuni, 12 were in the placebo group and 16 in the treatment group. After 2 days of treatment, none of the patients in the placebo group and 36% of those in the erythromycin group had normal stools (P less than 0.05). After 5 days of treatment, 50% of the patients in the placebo group and 93% of those in the erythromycin group had normal stools (P less than 0.02). Fecal excretion of the organism continued significantly longer in the placebo group (P less than 0.01). There were no treatment failures in the treatment group compared with five (42%) in the placebo group (P less than 0.01). Thus, early administration of erythromycin significantly reduced the duration of both diarrhea and fecal excretion of the organism in infants and children with acute dysentery associated with C. jejuni.

Campylobacter Infections↗
PubMed1989

Erythromycin ethylsuccinate, base and acistrate in the treatment of upper respiratory tract infection: two comparative studies of tolerability.

The efficacy and tolerability of erythromycin ethylsuccinate, erythromycin base and erythromycin acistrate were studied in two separate randomized studies in 80 and 82 primary health care patients with upper respiratory tract infections. In Study I, the patients were given either ethylsuccinate 666 mg tid or base 500 mg qid for ten days. Possible side-effects, abdominal pain, nausea, diarrhoea and vomiting, were recorded daily by the patient. Study II followed the same design as Study I with the exception of the side-effect evaluation method. Patients were given in a randomized fashion ethylsuccinate 666 mg tid, or acistrate 400 mg qid. Side-effect evaluation was based on a 10-cm analogue visual scale to record abdominal pain, while nausea, vomiting and diarrhoea were recorded as daily frequencies. These studies indicated that erythromycin ethylsuccinate caused significantly less abdominal pain than the base form (chi 2-test), but there were no significant differences in tolerance between the ethylsuccinate and acistrate forms. Other tolerance parameters revealed no real differences. The clinical response was good with all erythromycin preparations at the doses used in this study.

Adolescent↗
PubMed1965

DRUG ANTAGONISM BETWEEN LINCOMYCIN AND ERYTHROMYCIN.

An antagonistic action can be demonstrated between lincomycin, a new antibiotic, and erythromycin, when the two drugs are allowed to diffuse into the same area of an agar plate seeded with a strain of Staphylococcus which is resistant to erythromycin but sensitive to lincomycin. The increase in the minimum inhibitory concentrations of lincomycin in the presence of erythromycin may be significant in clinical application. The antagonism does not depend on a reaction between the two antibiotics, but appears to be the result of an altered metabolism stimulated by erythromycin on erythromycin-resistant staphylococci.

Anti-Bacterial Agents↗
PubMed1964

INDUCIBLE RESISTANCE TO ERYTHROMYCIN IN STAPHYLOCOCCUS AUREUS.

Weaver, Judith R. (Iowa State University, Ames), and P. A. Pattee. Inducible resistance to erythromycin in Staphylococcus aureus. J. Bacteriol. 88:574-580. 1964.-The dissociated resistance of Staphylococcus aureus to erythromycin was examined and was found to possess the characteristics of an inducible enzyme. The induction of resistance to high concentrations of erythromycin in S. aureus occurred only after prior exposure to subinhibitory concentrations of erythromycin. The only macrolide antibiotic examined which induced resistance was erythromycin, and the resistance of induced populations was rapidly lost when they were grown in the absence of this antibiotic. Induction did not occur when protein synthesis was inhibited by either chloramphenicol or histidine starvation of a histidine auxotroph. The macrolide antibiotics inhibited the induction of resistance at the same minimal concentrations required to inhibit growth and induced synthesis of beta-galactosidase. Therefore, the mode of action of the macrolide antibiotics is to inhibit protein synthesis, and the induction of resistance overcomes this inhibition in some manner which is associated with the synthesis of new protein.

Anti-Bacterial Agents↗
PubMed1979

Effect of chlorpromazine and erythromycin on bile salt-induced cholestasis in the rat.

The effects of subacute administration of chlorpromazine HCI (CPZ), erythromycine base and erythromycin estolate on the cholestatic response to intravenous taurolithocholate (TLC) and taurochenodeoxycholate (TCDC) in the rat were investigated. All three enhanced the recovery of bile flow after TCDC but not after TLC. Erythromycin base and estolate enhanced bile flow recovery after TCDC and potentiated the increase of plasma 5'-nucleotidase, as did CPZ. Neither erythromycin estolate nor CPZ precipitated a cholestatic response in rat maintained for 9-13 days on a diet supplemented with 0.05% lithocholic acid. It is concluded that the interaction of CPZ and erythromycins with bile salts is not based on the cholestatic properties of the drugs, and hence is not a practical way of distinguishing cholestatic from non-cholestatic drugs.

Alanine Transaminase↗
PubMed1984

Penetration of erythromycin in respiratory tract infections.

Successful treatment of respiratory tract infections with erythromycin may depend upon adequate penetration of the drug to the site of infection. The delivery of antibiotics into respiratory tract secretions is a simple passive diffusion process along a concentration gradient according to Fick's principle. A number of other factors including physicochemical characteristics of the drug and host defence mechanisms may further modify the tissue penetration. A common feature of penetration studies in respiratory tract infections is the wide range of results. This is due to the numerous variables involved in this kind of study. However, the studies performed at steady state, and after oral administration of erythromycin, show a rapid increase in drug concentrations in adenoid and tonsillar tissue homogenates and sustained levels equal to or higher than in serum. In secretions of the middle ear, paranasal sinuses and bronchiae the penetration and elimination of erythromycin is much slower. The drug levels were equal to--or in some cases even higher than--steady state serum concentrations. Fluctuations, however, were less pronounced. In lung tissue homogenates erythromycin concentrations higher than the serum levels have generally been found. In respiratory tract secretions and tissues the penetration of erythromycin is good. Sufficient levels are reached to inhibit in vitro the growth of most common pathogens involved in respiratory tract infections with the exception of some strains of Haemophilus influenzae.

Bacterial Infections↗
PubMed1988

Levels of erythromycin in tear fluid and serum in infants with conjunctivitis.

38 newborns with purulent conjunctivitis were treated with oral erythromycin ethylsuccinate 25 mg/kg every 12 h for 14 days. 3-4 days after initiation of therapy, erythromycin levels in serum and tear fluid were measured 1 and 12 h after the administration of erythromycin. The level of erythromycin in tear fluid was significantly higher than that in serum 1 and 12 h after administration of the antibiotic. On both occasions the concentrations of erythromycin in tear fluid and in serum exceeded the minimum inhibitory concentration (MIC) in vitro for Chlamydia trachomatis.

Chlamydia trachomatis↗
PubMed1957

International standard for erythromycin.

A batch of highly purified erythromycin A has been examined by 9 laboratories in 6 different countries, and has been assayed against the erythromycin standard of the Food and Drug Administration of the US Department of Health, Education, and Welfare. The material examined has been established as the International Standard for Erythromycin, and the International Unit of Erythromycin is defined as the activity contained in 0.001053 mg of the International Standard. The International Unit is, for practical purposes, equivalent to one mug of pure erythromycin base.

Biological Assay↗
PubMed1986

[Effect of erythromycin on the fecal flora of infants less than 1-year old].

Erythromycin ethyl succinate is an antibiotic frequently administered in pediatrics. According to some authors, this drug sharply decreases the fecal count of enterobacteria. The fecal flora of 12 infants less than one year old, treated by erythromycin ethyl succinate for 7 to 10 days was studied by differential count. A variable effect was observed on enterobacteria: a 10(3) to 10(5) fold reduction in 9 cases with a final count superior or equal to 10(4) per gram of feces, with or without coming back to the initial count; in 3 cases no modification. MIC of enterobacteria and concentrations of erythromycin in feces were not predictives of flora variation. Anaerobic flora was weakly modified. No implantation of potentially-pathogenic bacteria or multi-resistant or highly erythromycin resistant enterobacteria occurred. Thus, erythromycin ethyl succinate is valuable in pediatrics as it does not disturb barrier effects. But its use for selective decontamination of gut must be discussed depending on pharmacologic form and posology administered.

Enterobacteriaceae↗