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PubMed1991

Oral and injectable applications of erythromycin in salmonid fish culture.

Erythromycin is a macrolide antibiotic effective against Renibacterium salmoninarum, causative agent of bacterial kidney disease in salmonids. Although erythromycin is used on an experimental basis in private and conservation hatcheries, the drug is not registered with the US Food and Drug Administration for use in fish culture. Residues of erythromycin are retained in the tissues of juvenile and adult salmon for some time following administration of oral or injectable forms of the drug, a characteristic that may be important in the drug's efficacy against the slow growing R. salmoninarum pathogen. Before erythromycin can be registered, additional information must be collected about efficacy, toxicity, and environmental consequences of administration.

Administration, Oral↗
PubMed1991

Synergistic anti-Pneumocystis carinii effects of erythromycin and sulfisoxazole.

Pneumocystis carinii pneumonitis was effectively prevented in 90% of immunosuppressed rats by the administration of 100 mg of erythromycin and 300 mg/kg/day of sulfisoxazole. All of the untreated control and erythromycin-treated animals developed the infection and 80% of rats given sulfisoxazole alone had the pneumonitis. A similar pattern of response occurred when the drugs were used therapeutically for rats with established P. carinii pneumonitis. The erythromycin and sulfisoxazole ratio of 1:3 was the most effective of several dose combinations tested. The established safety record from three decades of clinical use of this drug combination plus the broad spectrum of coverage for other causes of diffuse pneumonitis such as Chlamydia, Mycoplasma, and Legionella warrant further study of erythromycin-sulfisoxazole in AIDS patients.

Animals↗
PubMed1991

[QT prolongation and circulatory arrest after an injection of erythromycin in a newborn infant].

A 8 day-old full-term newborn showed severe cardiac disturbances after intravenous injection of erythromycin. The neonate, suspected of having Chlamydia pneumonitis because of tachypnea and rhinitis, had been given 5 injections of erythromycin without clinical effect. Pallor, vomiting and bradycardia developed a few minutes after the 6th injection, and ECG showed ventricular arrhythmia, prolonged QT interval and an atrioventricular block. The infant died in intensive care unit. This case and the analysis of other published cases of cardiac disturbances following the parenteral use of erythromycin, indicate the potential arrhythmogenic risk of this drug. It is suggested that newborns treated with erythromycin should be monitored by ECG.

Erythromycin↗
PubMed1990

[Long-term therapeutic effects of erythromycin and newquinolone antibacterial agents on diffuse panbronchiolitis].

The present study reviewed and summarized the long-term therapeutic effects of erythromycin or newquinolone antibacterial agents on diffuse panbronchiolitis. Various parameters before and after the treatment were analyzed in 101 patients selected from 227 diffuse panbronchiolitis patients gathered from 26 institutes in Japan. Patients had been treated with either erythromycin or newquinolone antibacterial agent for more than 3 months. Patients treated with erythromycin showed significant improvement of dyspnea on exertion, findings of chest X-ray, data on blood gas analysis, rate of ESR, titer of cold coagulation and amount of sputum, compared with patients treated with the newquinolone antibacterial agent. Among the patients treated with erythromycin, those patients with the initial high cold coagulation titer showed better improvement following treatment. However, there was no significant difference in improvement, depending upon either the duration between the time of onset of the disease, the initiation of treatment, and the initial severity of the disease.

4-Quinolones↗
PubMed1990

Efficacies of erythromycin and chloramphenicol in extinguishing fecal shedding of Campylobacter jejuni in dogs.

Oral treatment regimens of erythromycin stearate and chloramphenicol were evaluated in naturally infected laboratory colony dogs for their efficacies in extinguishing fecal shedding of Campylobacter jejuni. Of the 25 Campylobacter-infected English Foxhounds in the study, 9 were assigned to erythromycin treatment, 9 to chloramphenicol treatment, and 7 to no treatment. Antimicrobials were administered for 12 days. All of the dogs that received erythromycin stearate ceased shedding C jejuni by the fourth day of treatment and remained negative throughout the treatment period. Chloramphenicol was associated with a reduction in shedding from 100% to 57% by the ninth day of treatment. Within 9 days of the discontinuation of antimicrobial treatment, C jejuni was isolated from all chloramphenicol-treated dogs and 89% erythromycin-treated dogs.

Animals↗
PubMed1989

Effect of erythromycin treatment on specific immunologic response in mice.

Six week old Swiss mice were sensitized by subcutaneous injection of 10(7) sheep red blood cells without adjuvant. One hour after sensitization, the mice were treated with erythromycin lactobionate for ten days. The minimal (15 mg/kg/day) and maximal (57 mg/kg/day) doses clinically used were assayed. The daily dose of erythromycin was administered intraperitoneally, in two injections, one every 12 hours. The kinetics of delayed type hypersensitivity reaction, measured by means of the foot-pad test, was evaluated by challenging different groups of fourteen mice with an eliciting dose of 10(8) SRBC injected into the foot-pad on days 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 after sensitization. Total and 2-mercaptoethanol resistant haemagglutinating antibody titres were determined in sera obtained from mice immediately after measuring the delayed type hypersensitivity reaction. Treatment with maximal erythromycin dose gave rise to a significant enhancement of the cellular immune response, and also to an acceleration of the humoral antibody response. On the other hand, treatment with minimal erythromycin dose gave rise to a slight depression of the immune cellular response and also to a depression of the antibody production at the beginning of the humoral response.

Animals↗
PubMed1989

[In vitro sensitivity of Mycobacterium avium and Mycobacterium xenopi to erythromycin, roxithromycin and doxycycline].

The comparative in vitro activity of erythromycin, roxithromycin and doxycycline against 20 isolates of M. avium and 20 M. xenopi was evaluated by two technics: a standard macrobroth dilution (7H9) and the 1% standard proportion method on lowenstein medium. M. avium was highly and uniformly resistant to doxycycline (MIC 50: 64 mg/l). For macrolides some strains were moderately susceptible to roxithromycin and at a lower level to erythromycin the MIC 50 and MIC 90 were respectively 8 and 16 mg/l for roxithromycin, 16 and 64 mg/l for erythromycin. Both macrolides were active against most of the strains of M. xenopi MIC 90 and MBC 90 were respectively 0.25 and 1 mg/l for roxithromycin, 0.5 and 2 mg/l for erythromycin. Doxycycline was less active inhibiting 90% of strains only at 16 mg/l.

Doxycycline↗
PubMed1987

Clinical and bacteriological evaluation of tetracycline and erythromycin in acne vulgaris.

A clinical and bacteriological comparison of tetracycline and erythromycin was carried out in 40 patients with papulopustular acne vulgaris. Twenty patients received 250 mg of tetracycline BID and 20 received 250 mg of erythromycin BID for four months. Clinically, 19 (95%) of patients treated with tetracycline and 17 (85%) of those treated with erythromycin had improvement ranging from moderate to very good. Both drugs also reduced the microflora both in the pustules and on normal skin from the same patients. Three patients given tetracycline and one given erythromycin reported mild side effects. Thus both antimicrobial agents were effective and safe in treating acne vulgaris.

Acne Vulgaris↗
PubMed1988

Erythromycin 2 percent gel in the treatment of acne vulgaris.

A gel formulation of erythromycin 2 percent was compared with its vehicle in a double-blind multicenter study involving patients with mild to moderate acne vulgaris. In an analysis of 187 patients treated twice daily for 8 weeks, erythromycin 2 percent gel proved to be significantly more effective than vehicle in reducing the numbers of both inflammatory and noninflammatory lesions. After 8 weeks, 60 percent of erythromycin-treated patients had good or excellent responses compared with 36 percent of those using vehicle (p = 0.001); the lesions in two patients using erythromycin were completely cleared. The majority of patients had a favorable impression of the cosmetic characteristics of the gel formulation.

Acne Vulgaris↗
PubMed1988

[Electrophysiological study of pro-arrhythmogenic effects of erythromycin].

Three cases of torsades de pointe induced by erythromycin have recently been reported. After observing a new case, the authors tried to demonstrate the possible mechanism of the arrhythmogenic action of this molecule. Twenty-two patients undergoing electrophysiological studies in the catheter laboratory to determine the cause of syncope were given an intravenous injection of 10 mg/Kg of erythromycin lactobionate. The drug was injected in 1 minute (bolus) in 11 patients (Group A). The other 11 patients (Group B) received the drug by slow intravenous infusion (20 minutes). Electrophysiological parameters were measured before and after erythromycin. A significant prolongation of the atrial refractory periods (+39 ms), ventricular refractory periods (+20 ms), QT (+20 ms) and QTC intervals (+42 ms) was observed in Group A. These electrophysiological effects could explain an arrhythmogenic action similar to that of antiarrhythmic drugs in Group I of Vaughan-Williams' classification. The slow intravenous infusion of erythromycin in Group B considerably reduced these undesirable secondary effects. This difference was directly related to serum concentrations of the molecule.

Adult↗
PubMed1987

A placebo-controlled, double-blind trial of erythromycin in adults with acute bronchitis.

Sixty-three otherwise healthy adults with acute productive cough and no clinical evidence of pneumonia were randomized to receive a ten-day course of erythromycin or placebo. Fifty-seven of these patients returned completed symptom diaries or returned for a two-week follow-up visit. Patients treated with erythromycin reported a more rapid improvement in subjective ratings of cold symptoms, general health, sputum production, and a mean symptom score. Fewer patients in the erythromycin group required cough or cold medications or were congested by day 10 (P less than .05). The treatment group was also less likely to have purulent sputum (9 percent vs 36 percent, P less than .05) and abnormal lung examinations (0 percent vs 29 percent, P less than .01) at a two-week follow-up visit. These results support the use of erythromycin in acute bronchitis.

Acute Disease↗
PubMed1986

Use of erythromycin in reducing vertical transmission of bacterial kidney disease.

Studies were conducted in 1980-1982 to determine uptake and retention of erythromycin when eggs of chinook salmon (Oncorhynchus tshawytscha) were water hardened for 1 hr in 2 ppm of the antibiotic as a means of preventing vertical transmission of bacterial kidney disease (BKD). Although eggs absorbed up to 1 ppm during water hardening, they retained the drug less than 24 hr. Injection of adult female chinook salmon with 11 mg of erythromycin/kg of body weight to prevent prespawning mortality from BKD resulted in deposition of drug in the eggs. Erythromycin persisted in the eggs at concentrations up to 0.6 ppm for 30 to 60 d postinjection--a period that would allow prolonged contact of drug with the causative agent of BKD, Renibacterium salmoninarum. Injection of prespawning female chinook salmon with erythromycin seemingly is potentially more effective than the water hardening of eggs in erythromycin in preventing vertical transmission of BKD.

Animals↗
PubMed1986

[Treatment with erythromycin of experimental legionellosis in guinea pigs infected by aerosol].

The infectious strain L. pneumophila serogroup 1 Philadelphia (ATCC 33152) was cultured on charcoal dialysed yeast extract agar medium (CDYE agar) which produces more virulent strains than those grown on classical agar media. The aerosol was dispersed in a depression chamber by means of a nebuliser and the density was controlled by a density probe. Male albinos Dunkin-Hartley guinea pigs weighing 250-300 g were exposed for 30 minutes to an aerosol dose of 1 LD50 (10(3) viable organisms) and 10 LD50 (10(4) viable organisms). Erythromycin lactobionate (Abbott) was administered subcutaneously 18 hours after the infection, at dosages of 270 mg/kg/day for 4 days in the animals treated with 1 LD50 and for 6 or 7 days in the animals treated with 10 LD50. The guinea pigs were observed for 9 days (weight, rectal temperature; serological and bacteriological tests (cardiac blood, lungs, spleen) and erythromycin assays (serum, lungs) were performed and compared in the treated animals, the non-treated infected control animals and the control animals which only received erythromycin. The percentage survival in the treated guinea pigs after inhalation of 1 LD50 and 10 LD50 (2 tests) were 100%, 75% and 87.5% respectively. Three weeks after treatment, the survivors had antibody titres from 32 to 1,024; the bacteriological cultures and erythromycin assays were negative. In this study, an improvement in the treatment of experimental Legionnaires' disease was observed in comparison with previous experiments. The increased dosage and duration and the early initiation of treatment resulted in survival rates of 75%.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Thin-layer chromatographic determination of erythromycin and other macrolide antibiotics in livestock products.

A method is described for determination of 4 macrolide antibiotics in livestock products. Erythromycin, tylosin, oleandomycin, and spiramycin were extracted from animal tissues, milk, and egg with acetonitrile at pH 8.5. Cleanup was done by adding sodium chloride and dichloromethane, evaporating the organic layer, and subsequent acid/base partitioning. After the antibiotics were separated by thin-layer chromatography (TLC), they were reacted with xanthydrol and could be detected as purple spots down to 0.02 mg/kg without interference by other commonly used therapeutic drugs (23 were tested). Anisaldehyde-sulfuric acid, cerium sulfate-molybdic acid, phosphomolybdic acid, and Dragendorff's reagent proved to be less sensitive as visualizing agents. For quantitation, TLC plates were scanned at 525 nm. Recoveries were between 71 and 96% for erythromycin and tylosin in liver, muscle, and egg at the 0.1-0.5 mg/kg level and 51% for erythromycin in milk at the 0.02 mg/kg level (coefficient of variation = 10-18%). Bioautography with Bacillus subtilis was used to confirm results, in addition to TLC analysis of derivatized antibiotics and liquid chromatography with electrochemical detection. Various derivatization procedures for erythromycin were investigated for improved ultra-violet or fluorescence detection in liquid chromatography.

Animals↗
PubMed1986

A pharmacokinetic drug interaction between erythromycin and triazolam.

The effect of erythromycin on the pharmacokinetics of triazolam was studied in 16 normal male volunteers. Triazolam in 0.5-mg doses was administered alone and after 3 days of receiving erythromycin (333 mg tid) in a randomized complete crossover design. Plasma samples were collected for 24 hours post doses and analyzed for triazolam by electron-capture gas chromatography. Erythromycin administration resulted in a 52% decrease in triazolam clearance, significantly higher triazolam concentrations at the majority of sampling times, significantly longer triazolam half-lives of elimination (5.9 vs. 3.6 hours), and a 30% decrease in the triazolam apparent volume of distribution. No differences were observed in the times of peak triazolam concentration occurrence. In accordance with previously reported drug interactions involving macrolide antibiotics, erythromycin appears to significantly inhibit the metabolism of triazolam.

Adult↗
PubMed1982

Evaluation of topical erythromycin and oral tetracycline in acne vulgaris.

A double-blind study was conducted to compare topical erythromycin 1.5 percent solution (Staticin solution) with oral tetracycline (250 mg) twice a day in fifty-four patients with Grades II and III acne vulgaris. Although both therapies produced a statistically significant reduction in the number and severity of the acne lesions, the topical preparation usually showed an effect earlier and to a greater degree than the oral medication. By the end of the study, some of these differences were statistically significant. After twelve weeks of treatment, topical erythromycin therapy produced a 58 percent reduction in the overall lesion count, as opposed to the 38 percent reduction produced by oral tetracycline therapy. In addition, the Propionibacterium acnes counts were reduced with erythromycin by over 90 percent and with tetracycline treatment by over 80 percent. Two patients treated with tetracycline developed vaginal candidiasis and therapy had to be discontinued. During topical treatment with erythromycin only mild adverse experiences were reported and none resulted in withdrawal from the study.

Acne Vulgaris↗
PubMed1983

[Antibiogram of mycobacteria for erythromycin, tetracycline and cotrimoxazole].

Disc method checks the bacterial susceptibility to erythromycin, tetracycline and cotrimoxazole, while the percentage method determines the MIC and the proportion of resistant bacilli at a critical concentration. The mycobacteria include 113 strains representing 12 species. Both methods show that cotrimoxazole is more active on germs than the other substances. Nevertheless, the sensitivity varies with the species, according to the technique. As the proportion method is a more reliable test to establish the susceptibility of mycobacteria, we have only used this technique to determine the activity spectrum of the various drugs. Specifically, M. marinum, M. scrofulaceum and M. szulgai are inhibited by the three substances, while M. kansasii, M. ulcerans and M. xenopi are especially sensitive to cotrimoxazole and erythromycin. M. fortuitum and M. haemophilum are particularly sensitive to cotrimoxazole, while they are resistant to erythromycin and tetracycline. It is the contrary with M. chelonei. M. avium and M. tuberculosis are sensitive to erythromycin and cotrimoxazole, but to a lower degree, while M. bovis does not respond to any drugs.

Drug Combinations↗
PubMed1981

Topical erythromycin vs blank vehicle in a multiclinic acne study.

A stable solution of erythromycin was developed using a vehicle of ethanol, propylene glycol, and citric acid buffer. In a controlled, randomized, double-blind comparison, a 2% solution of erythromycin applied to moderately severe facial acne was found to be superior to the blank vehicle in reducing the number of inflamed papules. During a period of 12 weeks, such papules were reduced by 56% in the erythromycin group, compared with 33% in the blank vehicle group. In the erythromycin group, 62% of the subjects had a good or excellent response, compared with 27% of those in the blank vehicle group. Adverse effects were similar in type in both groups and included redness, scaling, dryness, oiliness, burning, itching, and irritation of the eyes. No allergic reactions or skin infections were encountered.

Acne Vulgaris↗