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PubMedDate not supplied

[Ventricular tachycardia after erythromycin administration in a newborn with congenital AV-block].

UNLABELLED: This report is on a newborn with congenital complete av-block due to a maternal collagenosis. The intravenous application of erythromycin produced premature ventricular beats and non sustained ventricular tachycardias by prolongation of the QT interval. After discontinuation of the erythromycin application, the QT-interval normalised. CONCLUSION: In atrioventricular conduction disorders with severe bradycardia and prolongation of the QT interval, the application of erythromycin--if unavoidable--should be managed by slow intravenous infusion and with permanent ECG monitoring.

Anti-Bacterial Agents↗
PubMed2001

Ethnic differences and relationships in the oral pharmacokinetics of nifedipine and erythromycin.

OBJECTIVE: Our objective was to investigate ethnic differences in the oral pharmacokinetics of nifedipine and erythromycin, both typical cytochrome P4503A (CYP3A) substrates, in Koreans and Caucasians and to identify the nature of any correlations between the pharmacokinetic parameters of the two drugs. METHODS: Twenty healthy male volunteers (10 Koreans and 10 Caucasians) received single oral doses of nifedipine (10 mg) or erythromycin (500 mg) in a randomized 2-way crossover study. Pharmacokinetic evaluations were performed, and parameters were compared for the two ethnic groups. During the nifedipine study period, hemodynamic measurements were conducted to determine the pharmacodynamic relevance of the pharmacokinetic differences. RESULTS: Koreans showed area under the concentration-time curves (AUCs) for both drugs that were 1.6 to 1.7 times higher than those of Caucasians. This difference decreased to 1.3 when normalized for body weight. Significant correlation between the AUCs of the two drugs was not evident. Hemodynamic changes after nifedipine administration paralleled those of the pharmacokinetic differences, with significantly greater decreases in blood pressure and total peripheral resistance noted in Koreans. CONCLUSIONS: Koreans showed significantly lower oral clearances of nifedipine and erythromycin, probably because of genetic differences attributed to the CYP3A enzymes.

Adult↗
PubMed2003

Severe erythema nodosum due to Behçet's disease responsive to erythromycin.

A patient with severe erythema nodosum due to Behçet's disease is reported on here. Erythema nodosum lesions did not respond to classical treatments; however, they cleared after erythromycin treatment, which was prescribed for the treatment of coincidental erythrasma. Erythromycin treatment appears to be an effective treatment option in erythema nodosum. The hypothetical anti-inflammatory effects of erythromycin, besides its antibiotic properties, are reviewed and discussed to explain such a clinical improvement.

Administration, Oral↗
PubMed1990

In-vitro postantibiotic effects of miocamycin and erythromycin on gram-positive cocci.

The capability of miocamycin to induce a postantibiotic effect (PAE) on a Group A Streptococcus beta-haemolyticus clinical isolate and on Staphylococcus aureus ATCC 29213 has been studied. Erythromycin was chosen as a reference molecule. The exposure time to antibiotics was 90 min. The removal technique of the antibiotic agents consisted of a 1:200 dilution in cultural broth. Miocamycin displayed a PAE of 2 h 30 min in relation to the minimum inhibitory concentration (MIC) of Streptococcus and a PAE of 2 h 30 min in relation to the MIC of Staphylococcus. The PAE value lasting longer than the others was of 5 h 40 min towards Streptococcus and of 4 h 18 min towards Staphylococcus at a concentration eightfold the MIC. Erythromycin showed a PAE of 1 h 36 min in relation to the MIC of Streptococcus and a PAE of 1 h 30 min in relation to the MIC of Staphylococcus. The PAE value lasting longer than the others was of 3 h 15 min against Streptococcus and of 2 h 30 min against Staphylococcus at a concentration eightfold the MIC. In some cases a PAE was observed in relation to subinhibitory concentrations (1/2 MIC). Miocamycin therefore proved to possess a more evident capability to induce a PAE against the clinical isolate of Group A Streptococcus beta-haemolyticus and on Staphylococcus aureus ATCC 29213 than did erythromycin.

Adult↗
PubMed1992

Effects of miocamycin and erythromycin on polymorphonuclear cell function.

Previous studies have shown that erythromycin can enter phagocytic cells, stimulating their functional activity. In this work we compared the effects of erythromycin and another newer macrolide antibiotic, miocamycin, on a series of in vitro tests aimed at evaluating their influence on polymorphonuclear cell (PMN) functions. Results indicate that erythromycin induces an increase in leukotriene B4 production in PMNs, while chemotaxis, killing of Candida albicans and respiratory burst are not influenced, at least at the doses used in this study. On the contrary, all these activities are significantly enhanced following incubation with miocamycin, and the response varies according to the antibiotic concentration.

Candida albicans↗
PubMed2002

Failure of macrolide antibiotic treatment in patients with bacteremia due to erythromycin-resistant Streptococcus pneumoniae.

The rate of macrolide resistance among Streptococcus pneumoniae is increasing, but some investigators have questioned its clinical relevance. We conducted a matched case-control study of patients with bacteremic pneumococcal infection at 4 hospitals to determine whether development of breakthrough bacteremia during macrolide treatment was related to macrolide susceptibility of the pneumococcal isolate. Case patients (n=86) were patients who had pneumococcal bacteremia and an isolate that was either resistant or intermediately resistant to erythromycin. Controls (n=141) were patients matched for age, sex, location, and year that bacteremia developed who had an erythromycin-susceptible pneumococcus isolated. Excluding patients with meningitis, 18 (24%) of 76 case patients and none of 136 matched controls were taking a macrolide when blood was obtained for culture (P=.00000012). Moreover, 5 (24%) of 21 case patients with the low-level-resistant M phenotype and none of 40 controls were taking a macrolide (P=.00157). These data show that development of breakthrough bacteremia during macrolide or azalide therapy is more likely to occur among patients infected with an erythromycin-resistant pneumococcus, and they also indicate that in vitro macrolide resistance resulting from both the efflux and methylase mechanisms is clinically relevant.

Adolescent↗
PubMed2004

Effect of macrolide consumption on erythromycin resistance in Streptococcus pyogenes in Finland in 1997-2001.

The aim of this study was to investigate the association between regional macrolide resistance in Streptococcus pyogenes and macrolide use in Finland. During 1997-2001, a total of 50,875 S. pyogenes isolates were tested for erythromycin susceptibility in clinical microbiology laboratories throughout Finland. The local erythromycin resistance levels were compared with the regional consumption data of all macrolides pooled and, separately, with the use of azithromycin. The regional resistance rates of 1 year were compared with the regional consumption of the previous year and with the average rates of use for the 2 previous years. A linear mixed model for repeated measures was used in modeling the association. A statistically significant association existed between regional erythromycin resistance in S. pyogenes and consumption of macrolides; association with azithromycin use alone was not found.

Drug Prescriptions↗
PubMed2004

Evolution of erythromycin-resistant Streptococcus pneumoniae from Asian countries that contains erm(B) and mef(A) genes.

To investigate the genetic characteristics of erythromycin-resistant Streptococcus pneumoniae in Asian countries, 110 pneumococcal isolates were analyzed by multilocus sequence typing (MLST). MLST analysis showed that 2 clonal complexes--CC236 (Taiwan19F-14 clone) and CC81 (Spain23F-1 clone)--are the major lineages of erythromycin-resistant S. pneumoniae in the Asian region. Pneumococcal isolates containing both the erm(B) and the mef(A) genes are thought to have originated from the Taiwan19F-14 clone containing the mef(A) gene, after introduction of the erm(B) gene. Further evolution of this variant clone has generated resistant strains with different sequence types. Dissemination of these variant clones of the Taiwan19F-14 could be the main reason for the high frequency of pneumococcal isolates containing both erm(B) and mef(A) in some Asian countries. Data suggest that the high prevalence of erythromycin-resistant S. pneumoniae in the Asian region is partly due to the clonal spread of a few multidrug-resistant clones.

Asia↗
PubMed2006

Macrolide prescriptions and erythromycin resistance of Streptococcus pyogenes.

This study shows a significant association between the number of macrolide prescriptions reimbursed by the Italian National Health Service and resistance of Streptococcus pyogenes to erythromycin in children from a region in northern Italy with high prevalence of erythromycin resistance. Recent prescription of a macrolide (especially azithromycin) is a predictor of erythromycin resistance, as well as a possible risk factor for resistance at a community level.

Adolescent↗
PubMed2001

SmaI macrorestriction analysis of Italian isolates of erythromycin-resistant Streptococcus pyogenes and correlations with macrolide-resistance phenotypes.

High rates of erythromycin resistance among Streptococcus pyogenes strains have been reported in Italy in the last few years. In this study, 370 erythromycin-resistant (MIC, > or = 1 microg/mL) Italian isolates of this species obtained in 1997-1998 from throat swabs from symptomatic patients were typed by analyzing SmaI macrorestriction fragment patterns by pulsed-field gel electrophoresis (PFGE). Among the typable isolates (n = 341; the genomic DNA of the remaining 29 isolates was not restricted by SmaI), 48 distinct PFGE types were recognized, of which 31 were recorded in only one isolate (one-strain types). Fifty-two percent of typable isolates fell into three type clusters and 75% into six, suggesting that erythromycin-resistant group A streptococci circulating in Italy are polyclonal, but the majority of them probably derives from the spread of a limited number of clones. In parallel experiments, the 370 test strains were characterized for the macrolide resistance phenotype: 80 were assigned to phenotype cMLS, 89 to phenotype iMLS-A, 33 to phenotype iMLS-B, 11 to phenotype iMLS-C, and 157 to phenotype M. There was a close correlation between these phenotypic data and the genotypic results of PFGE analysis, the vast majority of the isolates assigned to individual PFGE classes belonging usually to a single phenotype of macrolide resistance. All of the 29 untypable isolates belonged to the M phenotype. Further correlations were observed with tetracycline resistance.

Anti-Bacterial Agents↗
PubMed2002

Erythromycin resistance in italian isolates of Streptococcus pyogenes and correlations with pulsed-field gel electrophoresis analysis.

Erythromycin resistance among Streptococcus pyogenes strains has been reported in Italy at high rates during the last few years. A total of 152 erythromycin-resistant isolates of this species from southern Italian regions were characterized for the macrolide-resistance phenotype and screened by PCR for the corresponding genetic determinant. A close correlation was found between these phenotypic/genotypic data concerning macrolide resistance and results of Sma I macrorestriction fragment patterns (PFGE) analysis. In fact, the vast majority of the isolates assigned to individual PFGE classes mostly belonged to a single phenotype of macrolide resistance. All untypeable isolates belonged to the M phenotype. Twenty-two distinct PFGE types were recognized, of which 11 were recorded in only one isolate (one-strain type); about 50% of typeable isolates fell into five type clusters and 70% in seven. The increased erythromycin resistance among Italian isolates of S. pyogenes does not appear to be due to the spread of a single clone, but results indicate that the majority of group A streptococci examined are probably spread from a limited number of clones.

Anti-Bacterial Agents↗
PubMed1998

Effects of co-trimoxazole, erythromycin, amoxycillin, tetracycline and chloroquine on sperm function in vitro.

This in-vitro study was designed to investigate the effects of commonly prescribed antibiotics on sperm movement characteristics, viability and the ability of spermatozoa to undergo the acrosome reaction. Spermatozoa were obtained by swim-up from normozoospermic semen and cultured for 24 h with increasing concentrations of co-trimoxazole, erythromycin, amoxycillin, tetracycline and chloroquine. Tetracycline at concentrations as low as 2.5 microg/ml led to a significant dose-dependent inhibition in percent rapid-moving spermatozoa, mean path velocity (VAP), straight-line velocity (VSL) and curvilinear velocity (VCL), but at 50 microg/ml tetracycline all spermatozoa were static. Erythromycin had significant effects on rapid movement, VAP, VSL and VCL only at concentrations >100 microg/ml. In contrast, percent rapid-moving spermatozoa was significantly enhanced at low concentrations of chloroquine (5 microg/ml), but significantly inhibited by higher concentrations. Co-trimoxazole did not adversely affect percent rapid-moving spermatozoa below 500 microg/ml, at which concentration movement was decreased by 34%. The mean lateral head displacement (ALH) was significantly enhanced by 5 microg/ml co-trimoxazole and reduced at 1 mg/ml erythromycin. The effects of these drugs were mostly irreversible. Amoxycillin had no effect on sperm movement characteristics over the dose range used, though it inhibited viability at high doses. Viability was significantly reduced at concentrations of all drugs which affect rapid sperm movement; these concentrations of drugs did not appear to affect the ability of spermatozoa to undergo the acrosome reaction. The results from this study, when combined with known effects on spermatogenesis, should facilitate the choice of drugs for the treatment of both genitourinary and unrelated infections in men who are attempting to conceive.

Acrosome Reaction↗
PubMed1978

Transfer of erythromycin resistance from clinically isolated lysogenic strains of Streptococcus pyogenes via their endogenous phage.

Endogenous bacteriophage from clinically isolated, erythromycin-resistant strains of Streptococcus pyogenes, upon induction by treatment with mitomycin C, were demonstrated to cause transduction of antibiotic resistance yielding transductants resistant to relatively high concentrations of erythromycin. Transduction of resistance to erythromycin via endogenous phage may play a significant role in the emergence of streptococci with multiple resistance in the clinical environment.

Bacteriophages↗
PubMed1983

Antimicrobial therapy of chancroid: effectiveness of erythromycin.

The emergence of Haemophilus ducreyi resistant to multiple antibiotics has limited the effectiveness of sulfonamides and tetracycline for the therapy of chancroid. A randomized, double-blind study compared 10-day courses of erythromycin base (500 mg) and rosaramicin (250 mg) each given four times daily for the treatment of men with chancroid in Nairobi, Kenya. Of 99 evaluable patients, 84 were positive for H ducreyi. H ducreyi-positive genital ulcers in men treated with either drug resolved with mean +/- SD healing times of 10.8 +/- 5.1 days for erythromycin and 10.7 +/- 5.5 for rosaramicin. There were no clinical or bacteriologic failures with either agent. Fifteen men with H ducreyi-negative genital ulcers for whom no other etiology could be determined also responded rapidly to treatment with either agent. Both erythromycin and rosaramicin are highly effective in the treatment of chancroid.

Adolescent↗
PubMed1987

Use of erythromycin to prevent pertussis in newborns of mothers with pertussis.

During the period 1975-1985, 35 women with serology- or culture-confirmed pertussis at the time of labor were admitted to the Danderyd Hospital (Danderyd, Sweden). In 32 cases, the mothers were allowed to nurse their newborns while receiving erythromycin therapy. Erythromycin prophylaxis was given to 28 newborns. None of the newborns developed clinical or laboratory signs of whooping cough. The therapy was well tolerated by the newborns and did not affect the microflora in the gut. Maternal antibodies to pertussis toxin and to the filamentous hemagglutinin were found in cord blood, and levels decreased during the follow-up period. The study demonstrated that mothers with pertussis can safely be allowed to nurse their infants if both receive erythromycin.

Antibodies, Bacterial↗
PubMed1988

Evidence for a high attack rate and efficacy of erythromycin prophylaxis in a pertussis outbreak in a facility for the developmentally disabled.

During an outbreak of pertussis in residents and staff of a facility for the developmentally disabled, 149 persons had laboratory evidence of Bordetella pertussis infection; 130 (87%) reported respiratory illness. Infection rates (IR) in affected wards ranged from 6% to 91%. Most residents were adolescents and adults and had received a full course of diphtheria-tetanus toxoids-pertussis (DTP) vaccine; IRs increased with increasing time after the last DTP dose in fully vaccinated residents. The IR was lower in residents on wards where erythromycin treatment/prophylaxis was started two or fewer weeks after the onset of illness in the first case on the ward (IR, 16%), compared with four or more weeks after onset (IR, 75%; P less than 10(-6)). Respiratory symptoms were milder in ill residents treated within seven days of onset of illness. Although B. pertussis transmission was substantial, erythromycin treatment of patients and prophylaxis of exposed persons was effective in decreasing transmission and disease severity. Carbamazepine toxicity occurred in seven (19%) of 37 residents when carbamazepine was administered with erythromycin.

Adolescent↗
PubMed1986

In-vitro activity of RU 28965, a new macrolide, compared to that of erythromycin.

The activity of a novel macrolide, RU 28965, was compared to that of erythromycin against Gram-positive organisms isolated mainly from cancer patients. RU 28965 was active against streptococci including Streptococcus pneumoniae and streptococcal groups A, B and G. It was also active against methicillin-susceptible staphylococci, Bacillus cereus and Listeria monocytogenes. Its activity against these organisms was generally equal to that of erythromycin. RU 28965 was moderately active against enterococci and inactive against JK diphtheroids and three different species of coagulase-negative staphylococci. Organisms resistant to erythromycin were also resistant to RU 28965.

Anti-Bacterial Agents↗
PubMed1986

Efficacy of pefloxacin in comparison with erythromycin in the treatment of experimental guinea pig legionellosis.

Pefloxacin was compared to erythromycin in the treatment of guinea pigs severely infected with Legionella pneumophila. In this experimental model, two single intraperitoneal injections of either pefloxacin (10 mg/kg at 48 h and 5 mg/kg at 55 h) or erythromycin (40 mg/kg at 48 and 55 h) were administered 48 h post-infection (2 X 10(7) virulent L. pneumophila intraperitoneally). Counts of bacteria in blood monocytes and lungs of animals killed at different times after the completion of treatment, demonstrated a quick and highly significant reduction of the pretreatment bacterial load in pefloxacin-treated guinea pigs. Conversely, in erythromycin-treated animals the number of bacteria was only slightly reduced 17 h after the completion of the treatment and then multiplication up to pre-treatment levels occurred. The overall mortality was significantly lower in pefloxacin-treated animals with this therapeutic protocol. The remarkable results of pefloxacin in this model, were obtained with serum and lung levels of this drug lower than those achieved in man with the currently accepted regimens. Thus, pefloxacin appears to be a new promising antimicrobial agent for Legionnaire's disease.

Animals↗