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At least 883 records · Page 49Linked to original sources
PubMed1993

Erythromycin induces supranormal gall bladder contraction in diabetic autonomic neuropathy.

Gall bladder motor function is impaired in some patients with diabetes. It has been suggested that the abnormalities of gall bladder motility are confined to those patients with autonomic neuropathy. Erythromycin, a motilin receptor agonist, causes gall bladder contraction in both normal subjects and patients with gall stones with impaired gall bladder emptying. The effect of erythromycin on gall bladder motility in seven patients with diabetes with an autonomic neuropathy, six patients with diabetes without autonomic neuropathy, and 17 normal subjects was studied using ultrasound. There was no significant difference in gall bladder fasting volume between the three groups, but the patients with diabetes with autonomic neuropathy had impaired postprandial gall bladder emptying compared with normal subjects (percentage emptied (SEM) 40 (10.3)% v 64 (2.8)%, p < 0.01) and those with autonomic neuropathy (48 (7.7)%, NS). Erythromycin produced a dramatic reduction in gall bladder fasting volume in patients with diabetes with an autonomic neuropathy, compared with either normal subjects or patients with diabetes without autonomic neuropathy (percentage reduction 62 (4.6)% in patients with autonomic neuropathy, v 37 (17.6)% in those without autonomic neuropathy, and 26 (7.3)% in the normal subjects, (p < 0.02) and returned gall bladder emptying to normal in all patients with impaired emptying. The pronounced effect of erythromycin in diabetic autonomic neuropathy suggests denervation supersensitivity and that the action of erythromycin on the gall bladder is neurally modulated.

Adult↗
PubMed1988

Pivampicillin compared with erythromycin for treating women with genital Chlamydia trachomatis infection.

In a randomised single blind study, pivampicillin was compared with erythromycin in women with urogenital Chlamydia trachomatis infections. The pivampicillin dosage was 700 mg twice a day and the erythromycin dosage 500 mg twice a day for seven days. Follow up took place on days 7 and 14 after the start of treatment. All 26 women treated with pivampicillin were culture negative for chlamydiae at the first and second follow up visits. All 23 women who received erythromycin were culture negative at the first follow up visit, but one was culture positive at the second follow up visit. Gastrointestinal side effects were recorded in five patients receiving pivampicillin and in nine receiving erythromycin. Two patients receiving erythromycin were withdrawn from treatment because of gastrointestinal disturbances, compared with none receiving pivampicillin.

Adolescent↗
PubMed2001

Directed neutrophil migration to IL-8 is increased in cystic fibrosis: a study of the effect of erythromycin.

BACKGROUND: The aim of this study was to compare neutrophil migration in cystic fibrosis (CF) and non-CF populations and to investigate the effect of erythromycin on directed migration of neutrophils (PMNs) in CF. METHODS: PMNs were isolated and their migratory capacity in response to interleukin-8 (IL-8) or f-Met-Leu-Phe (fMLP) in the presence or absence of erythromycin (1-100 microg/ml) was assessed. RESULTS: CF derived PMNs showed significantly increased migration to IL-8 but not to fMLP compared with non-CF PMNs. Erythromycin had no significant effect on migration responses to IL-8 and in vitro exposure of PMNs to erythromycin had no effect. CONCLUSIONS: CF derived PMNs show higher migratory responsiveness to IL-8 but not to fMLP, suggesting that CF PMNs may be "primed" to IL-8 which is significantly increased in CF serum compared with non-CF serum. Treatment with erythromycin had no significant effect on PMN migration in vitro.

Adolescent↗
PubMed1992

Effects of erythromycin in the dog upper gastrointestinal tract.

The effects of erythromycin on motor and electrical behavior of the antrum, pylorus, and duodenum were determined in chronically instrumented, awake dogs. Erythromycin infusion resulted in an abrupt, powerful increase in motility. The motility index increased 18-fold in the antrum, 15-fold in the pylorus, and 8-fold in the duodenum. Bradyarrhythmia with a 30% decrease in slow-wave frequency occurred in all animals. Retrograde giant contractions in association with retching and vomiting occurred in 88% of the dogs. Neostigmine was less potent than erythromycin in increasing motility. Hexamethonium given intra-arterially during erythromycin infusion abolished motility for 7.2 +/- 2.9 min and intra-arterial atropine did so for 51 +/- 25 min. Hexamethonium or atropine restored the electrical slow-wave frequency. The results provide evidence that erythromycin action involves cholinergic pathways including ganglionic transmission.

Animals↗
PubMed2005

Erythromycin increases bactericidal activity of surface liquid in human airway epithelial cells.

Macrolide antibiotics have clinical benefits in patients with diffuse panbronchiolitis and in patients with cystic fibrosis. Although many mechanisms have been proposed, the precise mechanisms are still uncertain. We examined the effects of erythromycin on bactericidal activity of airway surface liquid secreted by cultured human tracheal epithelial cells. Airway surface liquid was collected by washing the surface of human tracheal epithelial cells with a sodium solution (40 meq/l). Methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa were incubated with airway surface liquid, and the number of surviving bacteria was examined. The number of bacteria in airway surface liquid from the cells cultured in medium alone was significantly lower than that in the sodium solution. Furthermore, the number of bacteria in airway surface liquid from the cells treated with erythromycin was significantly lower than that in airway surface liquid from the cells treated with solvent alone. The production of mRNA and protein of human beta-defensin-1 and human beta-defensin-2 was significantly increased by erythromycin. Bactericidal activity of airway surface liquid was observed at low concentrations (40 meq/l) of sodium but not at higher concentrations (> or =80 meq/l). Airway surface liquid did not contain significant amounts of antibiotics supplemented in the culture medium. Erythromycin at the levels in airway surface liquid and in culture medium did not inhibit bacterial growth. These results suggest that erythromycin may increase bactericidal activity of airway surface liquid in human airway epithelial cells through human beta-defensins production and reduce susceptibility of the airway to bacterial infection.

Anti-Bacterial Agents↗
PubMed2002

Effect of low-dose oral erythromycin on gastric aspirates in ventilated neonates less than 32 weeks of gestation. Preliminary results.

In this prospective study, the 24-hour gastric aspirate volume was carefully recorded before, 24 and 48 h after administering 1.7 mg/kg/8-hourly of oral erythromycin to 16 ventilated neonates less than 32 weeks of gestation. Their median gestational age was 28.5 weeks (range 23-31 weeks), their median birthweight was 1,045 g (range 690-1,560 g) and the median day of life at which erythromycin was commenced was 9.5 days (range 4-16 days). Prior to administering erythromycin median 24-hour gastric aspirate volume, expressed as a percentage of the milk volume given over the same period, was 38.5% (range 20.0-100%). It was significantly lower 24 h (median 12%, range 0-41%, p = 0.0004) and 48 h (median 5%, range 0-21%, p = 0.0004) after commencing erythromycin. There was also significant reduction of gastric aspirate volume between 24 and 48 h after commencing erythromycin (p = 0.0024). Milk volume increment over the same period was not significant (p = 0.1022). These preliminary results warrant further evaluation through a randomised controlled trial.

Administration, Oral↗
PubMed2005

Efficacy of telithromycin in community-acquired pneumonia caused by pneumococci with reduced susceptibility to penicillin and/or erythromycin.

BACKGROUND: The efficacy of oral telithromycin was assessed in patients with community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae with reduced susceptibility to penicillin and/or erythromycin. METHODS: Patients with CAP who had received telithromycin 800 mg once daily for 5 or 7-10 days (n = 2,289) in eight phase III clinical trials, or telithromycin 800 mg once daily for 7 days (n = 50) in a phase II study were included in this pooled analysis. Patients with S. pneumoniae as the cause of infection were identified, with particular focus on those infected with strains with reduced susceptibility to penicillin (intermediate, minimal inhibitory concentration (MIC) 0.12-1.0 mg/l; resistant, MIC >or=2.0 mg/l) and/or resistance to erythromycin (MIC >or=1.0 mg/l). Per-protocol clinical and bacteriological outcomes were assessed 7-14 days post-therapy in the phase III studies, and at 7-21 days post-therapy or at the end of therapy in the phase II study. RESULTS: Of the 327 telithromycin-treated patients with S. pneumoniae infection, 61 (19%) were infected with strains with reduced susceptibility to penicillin and/or erythromycin. Clinical cure and bacterial eradication rates in these patients were 91.8% (56/61) and 93.4% (57/61), respectively. Corresponding clinical cure and bacterial eradication rates overall for all isolates of pneumococci were 94.5% (309/327) and 96.0% (314/327), respectively. All isolates with reduced susceptibility to penicillin and/or erythromycin were susceptible to telithromycin (MIC <or=1.0 mg/l). CONCLUSION: These results indicate that telithromycin is an effective oral antibacterial for the treatment of CAP caused by pneumococci with reduced susceptibility to penicillin and/or erythromycin.

Administration, Oral↗
PubMed1994

Effect of erythromycin on pancreatic polypeptide release: role of the vagal nerve.

To determine whether long vagal cholinergic pathways are involved in erythromycin-induced pancreatic polypeptide release, erythromycin was administered as an intravenous bolus injection to 9 healthy volunteers (group A) and to 13 patients (group B) with impaired vagal function as a result of truncal vagotomy or accidental vagotomy after antireflux surgery. In 7 of these patients (group B1) an antrectomy was also performed, while in the other 6 patients (group B2) the antrum was not removed. Pancreatic polypeptide was measured by radioimmunoassay at 5-min intervals twice before and at 2, 5, 10, 15, 30, 45 and 60 min after a 3.5 mg/kg bolus injection of erythromycin. On another day, a standard meal was administered and plasma pancreatic polypeptide was measured at 10-min intervals for 1 h. Erythromycin injection resulted in a lower integrated pancreatic polypeptide response in the patients of group B1 (247 +/- 89 pmol/l x 15 min; p = 0.005) and group B2 (497 +/- 111 pmol/l x 15 min; p = 0.05) when compared to the healthy subjects of group A (1,136 +/- 227 pmol/l x 15 min). The pancreatic polypeptide response to erythromycin in group B1 was reduced when compared to group B2, but the difference just failed to reach statistical significance (0.05 < p < 0.10). In the first 30 min after ingestion of a meal (cephalic phase) pancreatic polypeptide release was also markedly lower in group B1 (1,461 +/- 304 pmol/l x 30 min; p < 0.005) and group B2 (1,452 +/- 215 pmol/l x 30 min; p < 0.005) when compared to group A (3,541 +/- 452 pmol/l x 30 min).(ABSTRACT TRUNCATED AT 250 WORDS)

Depression, Chemical↗
PubMed1995

Inhibition by erythromycin of superoxide anion production by human polymorphonuclear leukocytes through the action of cyclic AMP-dependent protein kinase.

The long-term low-dose administration of erythromycin is effective in treating chronic inflammatory diseases of the lower respiratory tract. The aim of this study was to clarify the mechanism for this therapeutic effect of erythromycin. We measured its effect on the production of superoxide anion (O2-) by polymorphonuclear leukocytes (PMN) that was induced by N-formyl-methionyl-leucyl-phenylalanine (fMLP) or by phorbol myristate acetate (PMA). 25 microM erythromycin inhibited fMLP-induced O2- production by about 50%, but not PMA-induced O2- production. Moreover, this inhibition was overcome by adding an inhibitor of cyclic AMP-dependent protein kinase (PKA), H-89. The fMLP-induced O2- production was also inhibited by isoproterenol, a beta-adrenergic agonist, and by dibutyryl cyclic AMP, a cell membrane permeating analogue of cyclic AMP. The inhibition was also overcome by the addition of H-89. Therefore, the effect of erythromycin seemed to be, in part, mediated through the activation of PKA. The inhibition by erythromycin of O2- generation by PMN may contribute to the beneficial effect of this drug in treating chronic respiratory diseases.

Adrenergic beta-Agonists↗
PubMed1992

Assay of erythromycin in tape strips of human stratum corneum and some preliminary results in man.

The antibiotic erythromycin is used topically in the treatment of acne vulgaris. In order to evaluate the in vivo cutaneous absorption behavior of erythromycin in man, an analytical procedure for erythromycin in stratum corneum tape strips was developed. Erythromycin was extracted from tape strips using solid-phase extraction, followed by alkaline diethyl ether extraction. Reconstituted extracts were analyzed by RP-HPLC with electrochemical detection. This procedure proved to be adequate in a pilot experiment in man, topical erythromycin appearing to be distributed over the stratum corneum, its upper layers displaying an inward decreasing gradient.

Chromatography, High Pressure Liquid↗
PubMed1995

Effect of erythromycin on endotoxin-induced microvascular leakage in the rat trachea and lungs.

To determine whether the macrolide antibiotic erythromycin prevents microvascular leakage produced by lipopolysaccharide (LPS), we studied tracheae and lungs of pathogen-free rats. Tracheal vascular permeability and neutrophil recruitment were assessed by the percent area occupied by Monastral blue-labeled blood vessels and by myeloperoxidase-containing granulocytes, respectively, in tracheal whole mounts. Pulmonary microvascular leakage was evaluated by lung wet-to-dry (W/D) weight ratio. Inhalation of Escherichia coli LPS (5 mg/kg) caused time-dependent increases in tracheal vascular permeability, neutrophil influx, and lung W/D ratio. These responses were inhibited by pretreatment with oral erythromycin, but not by ampicillin or cefaclor, in a dose-dependent manner: erythromycin at 10 mg/kg daily for 1 wk reduced the area density of Monastral blue-labeled vessels from 6.7 +/- 1.2 to 1.4 +/- 0.3% (p < 0.01), the number of neutrophils (from 365 +/- 51 to 149 +/- 30 cells/mm2, p < 0.01), and lung W/D weight ratio (from 6.76 +/- 0.30 to 5.39 +/- 0.21, p < 0.01). This inhibitory effect of erythromycin was abolished by depletion of circulating neutrophils with cyclophosphamide. These results suggest that LPS causes acute lung injury, microvascular leakage, and neutrophil recruitment in the trachea, and that erythromycin protects against these changes, probably by acting on neutrophils.

Ampicillin↗
PubMed1983

The effect of erythromycin on theophylline pharmacokinetics in chronic bronchitis.

We examined theophylline pharmacokinetics for changes caused by the addition of erythromycin in patients with chronic bronchitis and obstructive pulmonary disease. Twelve hospitalized patients were randomized in a crossover fashion to receive aminophylline and either erythromycin or placebo. After the eighth dose, plasma was analyzed for theophylline, using the enzyme-mediated immunoassay technique. A 6-h urine collection was analyzed for theophylline metabolites, using high-pressure liquid chromatography. Erythromycin significantly decreased mean theophylline clearance by 22% from 4.9 L/min to 3.87 L/min (p less than 0.05). Mean peak theophylline levels increased 28% from 11.9 micrograms/ml to 15.3 micrograms/ml (p = 0.05). No change in urine theophylline metabolites was found. Patients with chronic bronchitis and obstructive pulmonary disease who begin erythromycin while receiving a preexisting therapeutic theophylline regimen experience a significant elevation of theophylline concentration, which predisposes to theophylline toxicity. For those patients with theophylline levels at the higher end of the therapeutic range (15 to 20 micrograms/ml), we recommend an initial 25% reduction in theophylline dosage when erythromycin is added. Serum theophylline levels should be monitored for further refinement of dosage.

Adult↗
PubMed1989

Erythromycin breath test as an assay of glucocorticoid-inducible liver cytochromes P-450. Studies in rats and patients.

The major P-450IIIA gene family member present in human liver is HLp which, like its rat liver orthologue P-450p, is inducible by glucocorticoids and catalyzes erythromycin N-demethylation. To develop a practical method to estimate the amounts of HLp in patients [14C]N-methyl erythromycin was injected into rats that had been pretreated with dexamethasone or with inducers of other forms of cytochrome P-450. The rate of demethylation of this substrate, measured simply as 14CO2 in the breath, correlated well with the concentrations of immunoreactive P-450p protein (r = 0.70), holocytochrome P-450p (r = 0.70), or with erythromycin N-demethylase activity (r = 0.90) determined in the liver microsomes prepared from each rat. Next, [14C]N-methyl erythromycin was administered to 30 patients and there was a sixfold interindividual variation in breath 14CO2 production seemingly unrelated to medications, smoking status or age. However, the average breath test values were twofold greater in female as compared to male patients (P less than 0.01). Breath 14CO2 production rose in patients retested after treatment with the P-450IIIA inducers dexamethasone (P less than 0.05) or rifampicin (P less than 0.05) and was decreased after treatment with the HLp inhibitor triacetyloleandomycin (P less than 0.05). We conclude that the erythromycin breath test provides a convenient assay of P-450IIIA cytochromes in rats and in some patients.

Adult↗
PubMed1997

A review of erythromycin-induced malignant tachyarrhythmia--torsade de pointes. A case report.

The term torsade de pointes refers to a ventricular tachycardia characterized by QRS complexes of changing amplitude that appears to twist around the isoelectric line and occurs at rates of 200-250/minute. Most cases of torsade de pointes are iatrogenically induced by drugs or electrolyte abnormalities. The most important feature is QT interval prolongation. Torsade de pointes was first described in 1966 in France by Dessertenne. The authors report a case of a fifty-year-old woman with medical history of corrective surgery for tetralogy of Fallot who was admitted to the hospital with pneumonia and atrial fibrillation and later developed recurrent episodes of polymorphic ventricular tachycardia with QT interval prolongation after i.v. administration of erythromycin. The episodes did not recur after discontinuation of erythromycin, and the QT interval returned to normal. The association of erythromycin with torsade de pointes has been reported in 18 cases to date. Erythromycin has been shown to produce electrophysiologic effects similar to those of class Ia and class III antiarrhythmic drugs on the cardiac muscle. This potentially fatal complication of a commonly used antibiotic is rare, but increased physician awareness is important, especially in patients with predisposing factors like electrolytes abnormalities, use of class Ia and Class III antiarrhythmic drugs, and presence of prolonged QT interval (congenital prolonged QT syndromes). This is the second case reported in a patient with previous cardiac surgery and erythromycin administration.

Anti-Bacterial Agents↗
PubMed1993

Erythromycin in acute laryngitis in adults.

Moraxella catarrhalis and Hemophilus influenzae are isolated from the nasopharynx in 50% to 55% and 8% to 15%, respectively, of cases of acute laryngitis in adults. This finding indicates that these organisms, M catarrhalis in particular, are in some way involved in the pathogenesis of the disorder. In the present double-blind, placebo-controlled trial, the effect of erythromycin ethylsuccinate (0.5 g twice a day for 5 days) on the elimination of nasopharyngeal pathogens and reduction of clinical signs of upper respiratory tract infection, as well as on subjective complaints, was evaluated in 106 adults with acute laryngitis. The bacterial isolation rates at presentation were M catarrhalis 50%, H influenzae 18%, and Streptococcus pneumoniae 4%. In the 99 patients who completed the study, the elimination of M catarrhalis after 1 week was better in the erythromycin group (25 of 30 cases) than in the placebo group (6 of 19 cases; p < or = .00038). The elimination of H influenzae was unaffected by erythromycin. Otolaryngologic examination did not reveal any significant group differences regarding laryngitis, pharyngitis, or rhinitis. Voice quality was improved after 1 week, irrespective of treatment. However, as compared to the placebo group, the erythromycin group reported fewer voice complaints after 1 week and fewer coughing complaints after 2 weeks. As acute laryngitis in adults is self-limiting, and subjective symptoms are spontaneously reduced after 1 week in most cases, antibiotic treatment does not seem warranted as a general policy. However, erythromycin may be justified in patients who are professionally dependent on voice function.

Acute Disease↗
PubMed1997

Ototoxic effect of erythromycin on cochlear potentials in the guinea pig.

The mechanism of hearing loss due to the administration of intravenous erythromycin was investigated in the albino guinea pig, and it was found for the first time that this drug causes cochlear dysfunction. The endocochlear potential (EP) and the cochlear microphonics (CM) recorded at the first cochlear turn transiently decreased when erythromycin was administered intravenously at dosages of 100 and 150 mg/kg. The averaged maximum decrease in EP was 16 mV (n = 5) and 33 mV (n = 5) for 100 and 150 mg/kg, respectively. The maximum decrease in the CM was about 25% when the EP reached its lowest value with the injection of 150 mg/kg. A complete recovery of the EP and CM ensured within 20 minutes after each erythromycin dose. The perilymphatic perfusion of 3 mmol/L of erythromycin decreased the EP and CM; however, in contrast to the intravenous administration, the decrease of the CM was nearly complete and both the EP and CM were irreversible. Hearing loss due to intravenously administered erythromycin could likely be attributle to the transient dysfunction of the stria vascularis, although concomitant dysfunction of the central auditory pathway cannot be excluded.

Animals↗
PubMed1977

Erythromycin in respiratory tract infection.

One of the main uses of erythromycin in respiratory tract infection has been in the treatment of acute streptococcal tonsillitis as an alternative to penicillin. Studies on the quantitative bacteriology of tonsils obtained at tonsillectomy have shown large numbers of both haemolytic streptococci and Haemophilus species in most samples and these organisms can be effectively reduced in number by preoperative treatment with antibiotics such as erythromycin. Such investigations suggest that erythromycin might have wider use in the treatment of respiratory tract infections, particularly where Haemophilus influenzae and other Haemophilus species are involved. Apart from specific infections such as those due to Mycoplasma pneumoniae, erythromycin is effective in the treatment of acute pneumonia due to organisms such as the pneumococcus, and this paper reports the further use of erythromycin in the treatment of acute exacerbations of chronic bronchitis where the clinical and bacteriological effects of treatment with this antibiotic are compared with those of ampicillin.

Ampicillin↗
PubMedDate not supplied

Simplified treatment of acute lower respiratory tract infection with azithromycin: a comparison with erythromycin and amoxycillin. European Azithromycin Study Group.

In two randomized, multicentre studies azithromycin treatment (1.5 g in five or six doses over 5 days) was compared with erythromycin treatment (14 or 20 g in 28 or 40 doses over 7 or 10 days) and amoxycillin treatment (10.5 g in 21 doses over 7 days) in patients with acute respiratory tract infection. In the two separate studies, azithromycin gave complete clinical cure in 70% and 51%, respectively, of patients compared with in 60% of erythromycin- and 45% of amoxycillin-treated patients. Eradication of the main pathogens isolated at baseline (Haemophilus influenzae, Streptococcus pneumoniae and Staphylococcus aureus) was comparable in the azithromycin, erythromycin and amoxycillin treatment groups. Efficacy was not affected by the presence or absence of underlying pulmonary disease. There were no major abnormalities in laboratory safety parameters and adverse events, principally mild/moderate gastro-intestinal symptoms occurred in 5% or 15%, respectively, of azithromycin-treated patients compared with in 18% or 17%, respectively, of those receiving erythromycin or amoxycillin. It is concluded that azithromycin was as effective and better tolerated than erythromycin or amoxycillin.

Acute Disease↗