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PubMed1987

The regression line for erythromycin is not valid for beta-hemolytic streptococci group A.

The antibacterial activity of erythromycin to 50 beta-hemolytic streptococci group A was assessed using disc diffusion and MIC techniques on solid media at pHs 6, 7 and 8 in CO2, aerobic and anaerobic atmospheres. The majority of the strains were only intermediately sensitive to erythromycin according to the disc diffusion method, whereas they were sensitive as judged by the MIC determination. This demonstrates that the regression line is invalid for the drug-bug combination of erythromycin and beta-hemolytic streptococci group A. It was also shown that the activity of erythromycin is reduced at a lower pH and in CO2 incubation.

Aerobiosis↗
PubMed1991

Erythromycin and phenoxymethylpenicillin (penicillin V) in the treatment of respiratory tract infections as related to microbiological findings and serum C-reactive protein.

Respiratory tract pathogens (beta-haemolytic streptococci groups A, C and G, Haemophilus influenzae, Branhamella catarrhalis or pneumococci), were isolated from nasopharyngeal and/or throat swabs in 73/138 (53%) patients greater than 10 years of age with a clinical diagnosis of acute sinusitis, acute tonsillitis, purulent nasopharyngitis or acute bronchitis. Serological evidence of a viral infection (influenza A and B, parainfluenza 1, 2 and 3, respiratory syncytial virus, adenovirus) or Mycoplasma pneumoniae infection was found in 10% of the patients. The serum content of C-reactive protein (S-CRP) was increased (greater than 12 mg/l) in 26/33 (79%) patients with streptococci and in 22/59 (37%) patients without respiratory tract bacteria. In patients with a serological evidence of a virus tonsillitis, the S-CRP was also high (32-64 mg/l). At follow-up 10-12 days after the first visit, the clinical effect of erythromycin and penicillin V was judged to be similar (90% clinical effect). Relapse or re-infection with group A streptococci were seen in 7 patients (4 on erythromycin, 3 on penicillin). In another 6 patients (3 on erythromycin, 3 on penicillin), antibiotic treatment was switched owing to persisting symptoms, probably due to H. Influenzae infection in 3 cases. The patients' own estimates of their symptoms suggested treatment with erythromycin to have a more rapid effect than treatment with penicillin.

Acute Disease↗
PubMed1982

Influence of erythromycin on the normal human flora and colonization of the oral cavity, throat and colon.

Erythromycin stearate was given orally in doses of 500 mg twice daily for 7 days to 10 volunteers. Saliva, throat and faecal specimens were taken up to 16 days for cultivation of aerobic and anaerobic bacteria. In specimens from saliva and throat only minor changes in the numbers of bacteria were detected during the antibiotic administration period, while pronounced changes in the aerobic and anaerobic faecal flora occurred. Thus among aerobes the number of enterobacteria significantly decreased and also the numbers of most anaerobes. During the erythromycin administration period, 8 subjects were colonized by erythromycin-resistant enterobacteria in the oral cavity and throat. All subjects were colonized by erythromycin-resistant enterobacteria, clostridia or yeasts in the colon. Many of the colonizing microorganisms were potential pathogens.

Adult↗
PubMed2005

Accumulation and clearance of orally administered erythromycin and its derivative, azithromycin, in juvenile fall chinook salmon Oncorhynchus tshawytscha.

Fall Chinook salmon Oncorhynchus tshawytscha were fed practical diets medicated with azithromycin (30 mg kg(-1) fish for 14 d) or erythromycin (100 mg kg(-1) fish for 28 d) either 1, 2, or 3 times beginning 14 d after initiation of exogenous feeding (February) and ending at smoltification (June). Average tissue concentrations of azithromycin increased from 19.0 microg g(-1) in fry to 44.9 microg g(-1) in smolts, and persisted in the tissues > 76 d after treatment ceased. Tissue concentrations of erythromycin were comparatively low, ranging from 0.2 microg g(-1) in fry to 10.4 microg g(-1) in smolts. Erythromycin was not detectable 21 d post-treatment. Neither antibiotic caused histopathologically significant lesions in the trunk kidney or other organ tissues. The high tissue concentrations and prolonged retention of azithromycin in Chinook may be factors that increase the efficacy of the antibiotic against Renibacterium salmoninarum, compared with erythromycin, particularly in early life history stages before covertly infected fish show clinical signs of disease.

Administration, Oral↗
PubMed1992

Activity of azithromycin (CP-62,993) and erythromycin against chloroquine-sensitive and chloroquine-resistant strains of Plasmodium falciparum in vitro.

Several antibiotics, including the macrolide erythromycin and the azalides azithromycin (CP-62,993) and CP-63,956, that inhibit protein synthesis on 70S ribosomes demonstrated antimalarial effects in vitro against two strains of Plasmodium falciparum, one sensitive to chloroquine and the other resistant. In 48-hr incubations, erythromycin was 10-fold less potent than the azalides against the chloroquine-resistant strain. Erythromycin and the azalides were essentially equipotent against the chloroquine-sensitive strain. An additive effect occurred with the azalides in combination with chloroquine against both strains, but this was not seen with erythromycin.

Animals↗
PubMed1981

In-vitro activity of erythromycin against anaerobic microorganisms.

Minimum inhibitory concentrations of erythromycin were determined, in the absence of CO2, for 256 strains of anaerobic microorganisms recently isolated from clinical practice. Of 126 strains of Bacteroides fragilis, 93% were inhibited by 6 mg/L, or less, of erythromycin. Of the remaining 130 isolates, 92% were inhibited by 6 mg/L, or less, of erythromycin. These findings suggest that the majority of anaerobic microorganisms would be inhibited by the serum levels achieved by administering 1 g of erythromycin intravenously, every six hours.

Bacteria↗
PubMed1987

Identification of novel erythromycin derivatives in mother liquor concentrates of Streptomyces erythraeus.

The identification of five novel compounds, pseudo-erythromycin A-6,9-hemiketal, 8,9-anhydro-pseudo-erythromycin A-6,9-hemiketal, 8,9-anhydro-pseudo-N-demethylerythromycin A-6,9-hemiketal, 5-O-beta-D-desosaminylerythronolide A and 15-nor-erythromycin C, in mother liquor concentrates of Streptomyces erythraeus is described. The pseudo-erythromycin derivatives are characterized by a 12-membered macrocyclic ring as a result of C13----C11 trans-lactonization. The five compounds have very little antimicrobial activity.

Bacteria↗
PubMed2004

Experience with directly observed prophylaxis using erythromycin in military trainees exposed to pertussis.

Pertussis, once a serious respiratory disease in children, has recently been identified as a common cause of chronic cough in adults. Military personnel are known to be vulnerable to this disease. After a training barracks exposure to pertussis, routine arrangements for contact prophylaxis with erythromycin failed. This experience is reported here as well as that of our subsequent aggressive attempts using directly observed prophylaxis (DOP) with standard erythromycin regimens. No secondary cases occurred. However, many contacts (35%) could not finish a 14-day course despite DOP, mostly because of nausea (85%) or diarrhea (72%). Seventeen (18%) soldiers missed classes because of erythromycin side effects; five required emergency department visits or hospital admission for the same. Sixteen (17%) soldiers were switched to azithromycin because of side effects; all were able to complete a 14-day course without symptoms. High adherence rates with erythromycin administration using DOP are attainable but may trigger unacceptable toxicities; alternative prophylactic regimens should be considered for active duty personnel.

Adult↗
PubMed1999

[Sensitivity of group A beta-hemolytic Streptococcus isolated from pediatric pharyngotonsillitis to erythromycin and clarithromycin: a primary care multicenter study].

BACKGROUND: The recent increase in the prevalence of macrolide-resistant group A beta-haemolytic Streptococcus (BHSGA) strains reported in some areas in Spain and several neighboring countries underscores the need to perform a periodic surveillance, with the adequate methodology, of the level of its susceptibility to these antimicrobials which are frequently used in our country for the treatment of acute streptococcal pharingotonsillitis and respiratory tract infections. PATIENTS AND METHODS: The susceptibility of 293 isolates of BHSGA to the macrolides erythromycin and clarithromycin was evaluated by the broth microdilution procedure recommended by the NCCLS (1997). The isolates were prospectively obtained from children with acute pharyngotonsillitis (n = 757) who were seen at primary care centers in ten Spanish cities. RESULTS: An overall prevalence of 8.9 and 7.8% erythromycin- and clarithromycin-resistant BHSGA isolates was respectively found. The percentage of resistant isolates varied considerably among the different cities subjected to study (0-33%). Overall, the intrinsic activity of clarithromycin (MIC50 and MIC90 of 0.007 and 0.25 mg/ml, respectively) was slightly higher than that of erythromycin (MIC50 and MIC90 of 0.015 and 0.5 mg/ml, respectively). All strains studied were uniformly susceptible to penicillin. CONCLUSIONS: Macrolide antibiotics, erythromycin and clarithromycin, continue to be highly active against BHSGA. The mean level of resistant strains found in Spain from community acquired infections and recovered prospectively is comparable to that of our neighboring countries.

Adolescent↗
PubMedDate not supplied

[The effect of erythromycin on immunity in immunodeficiency].

The effect of 12.5 and 25 mg/kg doses of erythromycin on the immunity of intact mice and in cyclophosphan- and azathioprine-induced immunodeficiency was studied. Erythromycin has no effect on the number of antibody-forming cells in the spleen of intact and immunocompromised with cyclophosphan animals. It increases their number against the background of azathioprine. Immunosuppression may change the character of the effect of erythromycin on delayed hypersensitivity. Erythromycin stimulates phagocyte activity in intact animals and in immunosuppression.

Animals↗
PubMed1978

[Distribution of erythromycin following intramuscular administration in laboratory animals].

Levels of erythromycin in the blood and organs of rabbits, rats and mice were determined after the i. m. implantation of the drug Erythromycin inj. ad usum vet. at doses of 10 mg kg-1 live weight (rabbits), and/or 25 mg kg-1 (rats) and 1 mg pro toto--approximately 40 mg kg-1 (mice). A diffusion plate method and the germ Sarcina lutea CCM 552 were used to find out the antibiotic in samples. Sensitivity of the method used was 0.025 microgram ml-1 (g). In rabbits the level of the antibiotic was maintained in the blood and examined organs and tissues (lungs, liver, kidney, muscles and the wall of the small intestine) by the above dose for more than 12 hours--except liver. The values obtained for the organs and tissues were mostly higher than those obtained for the blood. The highest levels were found in the kidneys and lungs. Neither did the dose of 20 mg kg-1 l. w. maintain the significant level of erythromycin in the blood serum in the course of 24 hours. The results obtained in rats and mice almost coincided with the distribution of erythromycin in the rabbit organisms, and the affinity of this antibiotic with the pulmonary tissue was proved.

Animals↗
PubMed1976

[Erythromycin penetration into the cerebrospinal fluid of patients].

Permeability of erythromycin through the barrier of blood-cerebrospinal fluid in neurosurgical patients after its oral administration in a dose of 300-500 mg and intravenous administration in a dose of 200 mg was studied. The erythromycin was determined after the antibiotic single administration at intervals of 40 minutes to 6 hours. A total of 31 observations were performed. Low penetration of erythromycin into the cerebrospinal fluid of the patients was shown. The administration route (oral or intravenous) practically had no effect on the antibiotic penetration level into the subarachnoidal spaces. The highest liquor levels were observed within the period of 3 to 6 hours after the drug administration. The maximum index of penetration from the blood into the cerebrospinal fluid was about 10 per cent. The erythromycin penetration increased in cases with inflammatory changes in the meninges.

Administration, Oral↗
PubMed1999

[Successful treatment of allergic bronchopulmonary aspergillosis with erythromycin and fluconazole].

A 30-year-old woman was admitted to our hospital because of productive cough, wheezing, and the disclosure of abnormal shadows on chest X-ray films. The patient was given a diagnosis of allergic bronchopulmonary aspergillosis (ABPA) based on eight findings: asthma, eosinophilia, elevated serum IgE concentrations, immediate skin reactivity to Aspergillus antigen, the presence of precipitating antibodies against Aspergillus antigen, lung infiltration, central bronchiectasis, and repeated culture of Aspergillus fumigatus in sputum. Because she refused steroids, we administered erythromycin. The volume of her sputum subsequently decreased, her symptoms were brought under control, and her serum IgE fell, but the lung infiltrates did not clear. Discontinuation of erythromycin resulted in exacerbation of the patient's asthmatic symptoms, with high fever, increased sputum volume and IgE levels, and worsening lung infiltrates. These symptoms responded well to oral prednisolone medication, but sputum culture was still positive for Aspergillus fumigatus. Following discontinuation of prednisolone, the patient was treated with erythromycin, to which oral fluconazole was added for 16 months. Subsequent sputum cultures were negative for Aspergillus fumigatus, and for 7 years thereafter the patient remained in remission. Erythromycin and anti-fungal drugs may be worth trying in cases of allergic bronchopulmonary aspergillosis.

Adult↗
PubMed1999

Erythromycin and gastroparesis? Off-licence use: uncertain efficacy for a poorly defined disorder.

(1) Erythromycin is sometimes used, without a licensed indication, for the treatment of gastroparesis by the oral or intravenous route. (2) Scintigraphic studies have shown that intravenous erythromycin accelerates gastric emptying, especially in diabetic patients and during the postoperative period when emptying is slowed. (3) No trials of acceptable quality have demonstrated any clear efficacy in the postoperative period. (4) In the other settings the clinical assessment of erythromycin is only just starting. There are no long-term trials or reliable comparisons with other prokinetic agents. (5) Erythromycin can give rise to many drug interactions, some of which (especially torsades de pointes) can have severe consequences.

Anti-Bacterial Agents↗
PubMed1999

Hypertrophic pyloric stenosis in infants following pertussis prophylaxis with erythromycin--Knoxville, Tennessee, 1999.

In February 1999, pertussis was diagnosed in six neonates born at hospital A in Knoxville, Tennessee. Because a health-care worker at hospital A was most likely the source of exposure, the local health department recommended on February 25, 1999, that erythromycin be prescribed as postexposure prophylaxis for the approximately 200 infants born at hospital A during February 1-24, 1999. In March 1999, local pediatric surgeons noticed an increased number of cases of infantile hypertrophic pyloric stenosis (IHPS) in the area, with seven cases occurring during a 2-week period. All seven IHPS cases were in infants born in hospital A during February who were given erythromycin orally for prophylaxis following possible exposure to pertussis, although none had pertussis diagnosed. The Tennessee Department of Health and CDC investigated the cluster of IHPS cases and its possible association with use of erythromycin. This report summarizes the results of the investigation, which suggest a causal role of erythromycin in this cluster of IHPS cases.

Anti-Bacterial Agents↗
PubMed1997

[The value of erythromycin pleurodesis in the treatment of malignant pleural effusions].

Malignant pleural effusion is a frequent complication of patients with advanced malignant tumors. For many patients suffering from malignant pleural effusion that increases rapidly and may be life threatening, it is important to control the effusions. To investigate the value of erythromycin as a pleural sclerosant, a dose of 1 g erythromycin in 30 ml of 5% glucose was injected into the pleural cavity of 26 patients with malignant pleural effusion. The results were assessed by Miller's standards. After treatment, numerous adhesions were present in 15 cases; Pleural effusion reduced in 7 patients, and no effect was noted in 4 patients. The total response rate was 84.6%, and there were no severe side-effects. The erythromycin-induced pleurodesis is probably the result of induced chemical inflammation in the locality. This study suggests that erythromycin is a useful pleural sclerosant.

Adenocarcinoma↗
PubMed2000

Erythromycin for chlamydiasis in pregnant women. Assessing adherence to a standard multiday, multidose course.

OBJECTIVE: To assess patient adherence among pregnant women infected with Chlamydia trachomatis given a self-administered, 10-day course of erythromycin prescribed as 500-mg tablets to be taken four times a day for the full 10-day period of treatment. STUDY DESIGN: Study participants (n = 30) were given the standard, 10-day supply of 500-mg tablets of erythromycin and instructed to take one tablet four times daily for 10 days. Patients were blinded to the fact that the Medication Event Monitoring System was being used and that their adherence to this course of drug therapy was being monitored. RESULTS: A 100% cure rate was achieved. The average percentage of therapeutic coverage actually achieved by the study participants declined with the length of erythromycin therapy. Further, as the duration of treatment increased, the longest interval between two successive doses of erythromycin also increased. CONCLUSION: This study demonstrated the importance of assessing both the quantitative and temporal aspects of self-administered oral medication when assessing patient adherence. Moreover, since the length of the course of antibiotic therapy was shown to affect patient adherence, coupled with the 100% cure rate we observed, future research geared toward maximizing adherence while minimizing duration of treatment seems warranted.

Adult↗
PubMedDate not supplied

[Formation of erythromycin resistance in Corynebacterium diphtheriae induced by long-term effect of the antibiotic].

Erythromycin resistance induced in Corynebacterium diphtheriae strains by subinhibitory concentrations of this antibiotic has been investigated. Six strains of C. diphtheriae highly susceptible to erythromycin were grown in the broth with 0.5 minimal inhibitory concentration (MIC). After 23-25 cultivations the susceptibility to erythromycin in the strains tested began to decrease gradually. After 46-52 consequent cultivations the strains became moderately resistant, and after 60-72 ones 5 cultures became resistant. The induced resistance to erythromycin was associated with that to oleandomycin. The strains of C. diphtheriae with induced resistance had no changes in morphology of colonies, saccharolytic and adhesive properties and toxigenicity, but their growth was slower than that of the original strains.

Animals↗