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PubMed1993

[Antro-pyloro-bulbar contractibility in diabetics studied by cineradiography. Effect of erythromycin].

We studied antropyloroduodenal contractility in diabetics and the effect of erythromycin IV (100-500 mg) using the non invasive Boiron cineradiographic method analysis. Fourteen diabetics and 22 controls were examined. Four hours after a standard liquid-solid meal, patients drank 250 mL baryum solution. Fluorographic plates (10 x 10 cm) were taken every 2 s during 30 s. Semi-automatic data processing analysis allowed to measure motility parameters including antral (CA) and bulbar (CB) contractility indexes; pyloric opening index (OP), gastric (FG) and bulbar (FB) frequencies. Three types of pylorus behaviour patterns were define: A and B related to antropyloric and antropyloroduodenal coordination respectively and N without coordination. In diabetics, CA, OP and FG were decreased vs controls (P < 0.01) (CA: 65.5 +/- 6.8 vs 83.1 +/- 2.4%; OP: 60.9 +/- 8.7 vs 84.8 +/- 1.9%; FG: 2.42 +/- 0.14 vs 3.08 +/- 0.04 c/min) and antropylorbulbar coordination altered (N was predominant; no bulbar cycles at 3/min). Antral hypocontractility was correlated with autonomic neuropathy. After erythromycin, radiological parameters returned to normal values (CA = 83.0 +/- 2.4%; OP = 86.0 +/- 4.7%; FG = 3.0 +/- 0.16 c/min) and coordination improved type N disappeared and FB = 3 c/min (58%). Cineradiographic analysis is simple, able to show antropylorobulbar contractile abnormalities, to study pharmacological effects, and in diabetics is capable of studying improvement of motility parameters with erythromycin.

Adult↗
PubMed1993

Effect of intravenous erythromycin on postoperative ileus.

We attempted to determine whether the administration of erythromycin shortens the period of postoperative ileus by a prospective, double-blind, placebo-controlled study. Seventy-seven patients were randomized and included in the statistical calculations. The patients were stratified according to the operation performed (cholecystectomy, celiotomy, or other major abdominal operations). Forty-one patients (group 1) received 250 mg erythromycin intravenously every 8 h for nine doses upon admission to the recovery room. Thirty-six patients (group 2) received placebo. The time (in hours) to first passage of flatus, first liquid meal, first bowel movement, and total length of hospital stay was recorded. There was no significant difference between group 1 and group 2 in time to first flatus (54.9 +/- 29 vs. 53.9 +/- 27 h, respectively), first meal (70.4 +/- 44 vs. 71.7 +/- 65), first bowel movement (81.8 +/- 32 vs. 80.1 +/- 28), or length of hospital stay (185.2 +/- 183 vs. 182.1 +/- 163). Erythromycin, in the dosage tested in this study, does not seem to alter clinical parameters of gastrointestinal motility after an abdominal operation. New prokinetic agents may deserve further studies.

Abdomen↗
PubMed1995

[Excretion of erythromycin, clindamycin and lincomycin into the saliva].

In rabbit experiments (n = 10) the salivary and serum levels of several antibiotics were studied after per os (clindamycin, erythromycin and lincomycin) and iv. (erythromycin) administration. Erythromycin was excreted into the saliva in a considerable degree (in 60-75% of the serum level) and displayed therapeutical levels for 5-6 hrs, whereas clindamycin and lincomycin reached in the saliva only 25-30% of the serum level and therapeutic levels were maintained only for 3 hours.

Administration, Oral↗
PubMed1977

[Acute side effects of erythromycin, lincomycin and clindamycin].

After some introductory remarks on the pathogenetic mechanisms of acute undesirable reactions following the administration of antibiotics, the incidence of vascular shock (anaphylactic shock, anaphylactoid shock) is discussed. Investigations were performed to obtain information on the sensitizing capacity of erythromycin and clindamycin in rats and guinea pigs. Although maximation procedures were used, no sensitization could be obtained, in contrast to similar series with penicillin and sulfonamides. In another experimental series, the anaphylactoid properties of erythromycin and clindamycin were studied in vitro. The dye-kick-off test and the mast-cell-degranulation test were used. No pronounced anaphylactoid activity, either of the cellular or of the humoral type, was found in the two antibiotics investigated. The results of the animal experiments and the experiments in vitro are in good accordance with clinical experience: erythromycin and clindamycin rank among the safest antibiotics with regard to the elicitation of acute undesirable actions.

Anaphylaxis↗
PubMed1995

Low dose erythromycin regimen for the treatment of chancroid.

Haemophilus ducreyi is the commonest cause of genital ulcer disease in Africa and is associated with heterosexual transmission of human immunodeficiency virus(HIV). The World Health Organization currently recommends erythromycin 500 mg three times a day for seven days as the treatment of choice for Haemophilus ducreyi infection. We studied the effectiveness of a lower dose erythromycin treatment regime, 250 mg three times a day for seven days in the treatment of chancroid. Patients with genital ulcer disease presenting at Nairobi City council clinic between January and March, 1992 were recruited into the study. Swabs were taken from the ulcers for Haemophilus ducreyi and venous blood was screened for syphilis and HIV antibodies. A total of 219 patients were enrolled for the study and were reviewed on days seven and fourteen for side effects, bacteriological and clinical cure rates. 26.4% of the study population were HIV-1 seropositive. The treatment regime was well tolerated and effective in both HIV seropositive and seronegative patients. Complete bacteriological cure rate was achieved in Haemophilus ducreyi culture positives by day seven irrespective of the HIV serostatus. However, the clinical cure rate for HIV seropositive patients was 88% compared to 99% for seronegative patients (p<.001). It is concluded that a low dose erythromycin is an inexpensive and effective treatment for chancroid with complete bacteriological cure rate, although the healing process takes longer in HIV seropositive patients.

Adult↗
PubMed1977

Prostatic tissue and secretion concentrations of rosamicin and erythromycin. Experimental studies in the dog.

In dogs with normal and infected prostate glands, a new antibacterial substance, rosamicin, chemically a lipid soluble basic macrolide similar to erythromycin but with a better activity against Gram-negative bacteria, was tested, and compared to erythromycin in normal dogs. The two antibiotics were administered by constant intravenous infusion for 4 hr and their concentrations in plasma, urine, prostatic tissue, and secretion were determined by bioassay technique. Rosamicin was highly concentrated in the secretion of both the normal and the infected prostate gland, although in the latter the antibiotic levels were significantly lower. Erythromycin was significantly less concentrated than rosamicin in the prostatic secretion from normal prostates and was also less concentrated in normal prostatic tissue. Inasmuch as rosamicin has an improved antibacterial spectrum, which is well suited for the treatment of bacterial prostatitis, it should be investigated in this respect.

Animals↗
PubMed1996

[Acetaminophen absorption test for determination of diabetic gastroparesis and effects of erythromycin on gastric emptying].

The purpose of this study is to know the incidence of diabetic gastroparesis in diabetics and its relationship with diabetic neuropathy and to direct rational clinical treatment. Acetaminophen absorption test was performed for determination of gastric emptying function of liquid in 43 patients with diabetes mellitus (male 23, female 20, mean age 53.5 years). The patients were divided into two groups: diabetics with and without autonomic neuropathy. The change of gastric emptying time (GET) after intravenous administration of erythromycin (100 mg/h) was observed. The results showed that GET in diabetics was significantly prolonged. The incidence of abnormal gastric emptying function of liquid was 51.16%. GET in diabetics with neuropathy was significantly longer than that in those without neuropathy (42.83 +/- 13.80 min vs 26.00 +/- 11.42 min, P < 0.01). Its incidence was significantly increased in diabetic neuropathy and related to its severity. Delayed GET in diabetics was normalized after erythromycin administration (from 47.63 +/- 6.74 min to 20.53 +/- 7.43 min, P < 0.01). The results indicate that this test can be used as an objective indicator for diabetic gastric autonomic neuropathy and gastroparesis. Erythromycin accelerates gastric emptying.

Absorption↗
PubMedDate not supplied

A bacterial sensitivity test to determine the effectiveness of minocycline HCI (Minocin), erythromycin (Erythrocin) and ampicillin (Ampicin) on the predominant microorganisms present in a diseased periodontium.

The purpose of this study was to determine the effectiveness of the three antimicrobials--Minocycline HCI, Erythromycin and Ampicillin based on the percentage reduction of bacteria present in subgingival microflora and in vitro assessment of antibiotic susceptibility of cultured strains of predominant microorganisms present in a diseased periodontium. Twelve volunteers 18 to 65 years of age, with moderate to severe periodontal disease, were randomly divided into Group A and Group B of 6 members each. Oral lavage procedure was performed to Group A and Group B received systemic administration of antibiotic for five days. Patients 1 & 2, 3 & 4 and 5 & 6 received minocycline HCI, Erythromycin and Ampicillin respectively. Microbiologic samples in the subgingival crevicular area in selected tooth exhibiting clinical periodontal breakdown were obtained from all the subjects prior to and after the oral lavage procedure and systemic drug administration. Streptococcus viridans is the most predominant aerobic microorganism obtained from 83% of samples. However no anaerobic microorganism has been isolated. Bacterial sensitivity testing showed 60% of samples with positive growth of microorganisms (S. viridans) were also equally sensitive to Minocycline HCI, Erythromycin and Ampicillin. Oral lavage proved to be ineffective in reducing the number of bacteria. However, systemic drug administration revealed that there was a reduction in bacterial count after taking such antibiotics for five days which is more favorable to Minocycline HCI.

Adolescent↗
PubMed2002

Detection and characterization of erythromycin-resistant methylase genes in Gram-positive bacteria isolated from poultry litter.

The epidemiology of four erythromycin-resistant methylase ( erm) genes, ermA, ermB, ermC and msrA, was determined in erythromycin-resistant staphylococci, enterococci and streptococci isolated from poultry litter. All isolates were resistant to multiple antibiotics. Southern hybridization indicated that 4 of the 20 staphylococci contained the ermC gene on plasmids: on a 2.2 kb plasmid in Staphylococcus hominis and S. sciuri, on a 6.0 kb plasmid in S. xylosus, and on a 7.0 kb plasmid in S. lentus. In 16 of the 20 staphylococci, the ermA gene was harbored exclusively on the chromosome, as a double chromosomal insert on 8.0 and 6.2 kb EcoRI fragments. None of the staphylococci harbored the msrA gene. Dot-blot analysis indicated that all enterococci and streptococci hybridized with a biotinylated ermB gene probe. Southern hybridization indicated that only 2 of the 19 erythromycin-resistant enterococci contained the ermB gene on plasmids. The gene was localized on 4.0 kb and 5.9 kb plasmids, respectively, in two Enterococcus faecium isolates. Results from our studies indicate that the patterns of occurrence of erm genes, the sizes of the plasmids and the copy numbers of the inserts were different from the existing information on the presence of erm genes in clinical strains of Staphylococcus spp.

Animals↗
PubMed1998

Quantitative determination of the macrolide antibiotics erythromycin, roxithromycin, azithromycin and clarithromycin in human serum by high-performance liquid chromatography using pre-column derivatization with 9-fluorenylmethyloxycarbonyl chloride and fluorescence detection.

A validated, highly sensitive and precise high-performance liquid chromatographic (HPLC) method for the determination of the macrolides erythromycin, azithromycin, clarithromycin and roxithromycin in human serum is described. A diethyl ether extract, obtained from serum using a saturated sodium carbonate solution, was treated with 9-fluorenylmethyl-oxycarbonyl chloride (FMOC-Cl) for 40 min at 40 degrees C and chromatographed on a base-deactivated octadecyl column, maintained at 50 degrees C during elution, using an eluent composed of acetonitrile-hydrogenphosphate buffer, pH 7.5, with 0.125% triethylamine (3:2, v/v). Fluorescence detection was used at an excitation wavelength of 255 nm and an emission wavelength of 315 nm. Erythromycin, clarithromycin, roxithromycin and azithromycin were found to have retention times of 8.8, 15.7, 17.1 and 20.7 min, respectively. Recoveries ranging from 93 to 104% were found with reproducibility coefficients of variation of 1.1-5%. Mean correlation coefficients of 0.9997, 0.9998, 0.9996 and 0.9994 were found for the linear calibration curves (n = 2) of erythromycin (0.320-16.1 mg/l), roxithromycin (3.24-19.4 mg/l), clarithromycin (0.190-19.4 mg/l) and azithromycin (0.0988-4.94 mg/l), respectively.

Anti-Bacterial Agents↗
PubMed1962

APPLICATION OF THE MEMBRANE FILTER FOR THE QUANTITATIVE STUDY OF TRANSFORMATIONS WITH PARTICULAR REFERENCE TO PHENOTYPIC EXPRESSION OF AN ERYTHROMYCIN-RESISTANCE MUTATION.

Iyer, V. N. (University of Rochester, Rochester, N.Y.). Application of the membrane filter for the quantitative study of transformations with particular reference to phenotypic expression of an erythromycin-resistance mutation. J. Bacteriol. 84:326-330. 1962.-A technique using membrane filters for quantitative studies of transformation of pneumococci is described and some possible applications discussed. This method has been found amenable to the study of the integration and phenotypic expression of an erythromycin-resistance mutation of pneumococci which is characterized by a low frequency of transformation and delayed expression. The expression of survival occurs prior to the expression of colony-forming ability in the presence of erythromycin.

Journal Article↗
PubMed2001

[A case of Legionella pneumonia successfully treated intravenously with both erythromycin and ciprofloxacin].

A 54-year-old man was admitted to our hospital complaining of a high fever and watery diarrhea. The chest radiograph on admission revealed a homogeneous consolidation of the left upper lobe. Laboratory findings included proteinuria, oligouria, hematuria, myoglobinuria, hyponatremia, and serum CPK elevation. On the basis of these findings, a tentative diagnosis of Legionella pneumonia was made. He was treated with sulbactam/cefoperazon and erythromycin, but his high fever remained and the consolidation shadow deteriorated. He was therefore given both erythromycin and ciprofloxacin intravenously. After several days the fever had returned to normal, the appearance of the chest radiograph had improved, and his symptoms were quickly relieved. This case suggests that intravenous administration of ciprofloxacin and erythromycin can be an effective treatment against Legionella pneumonia.

Anti-Infective Agents↗
PubMed1983

Erythromycin in treatment of Campylobacter enteritis in children.

Erythromycin ethylsuccinate therapy was compared with no treatment in a randomized, prospective trial of treatment of Campylobacter enteritis in infants and children. Patients received either erythromycin ethylsuccinate (N = 15), 40 mg/kg/day every six hours, for seven days or no treatment (N = 12). The mean age (5.5 v 3.7 years), sex ratio, and mean duration of illness before admission to study (5.5 v 6.4 days) of the two groups were similar. No difference was noted in the mean days to resolution of diarrhea (3.2 v 3.8 days). However, the mean duration of bacterial shedding was shorter in the treatment group (2.0 days) compared with the group without treatment (16.8 days). Bacteriologic relapse occurred in one patient in the treatment group, and three relapses occurred in the group without treatment. Two secondary cases occurred among household contacts, one in each group.

Campylobacter Infections↗
PubMed1985

Topical sulfacetamide vs oral erythromycin for neonatal chlamydial conjunctivitis.

Conjunctival and nasopharyngeal cultures for Chlamydia trachomatis were obtained from infants 30 days of age or younger with purulent conjunctivitis. Conjunctival specimens were also tested for other bacterial pathogens and for viruses. Most of the infants studied were black and came from a low-income, urban population. By random assignment infants received either topical treatment with 10% sulfacetamide sodium ophthalmic solution or systemic treatment with oral erythromycin estolate (50 mg/kg/day). Treatment was continued for 14 days if C trachomatis was isolated from the conjunctivae. Treatment was considered to be effective if conjunctivitis resolved and if follow-up chlamydial cultures of the conjunctivae and nasopharynx were negative at completion of therapy and two to four weeks later. Chlamydia trachomatis was isolated in the absence of other pathogens from the eyes of 37 (73%) of 51 infants with conjunctivitis. Other bacterial pathogens were isolated from four infants (8%) and viruses from none. Chlamydial infection was eradicated from 14 (93%) of 15 infants treated orally. In contrast, persistent conjunctival infection was detected in eight infants (57%) and nasopharyngeal colonization in three (21%) of 14 infants after topical treatment. It was concluded that C trachomatis is the most frequent cause of neonatal conjunctivitis in the low-income, urban population studied; that erythromycin estolate administered orally for 14 days eradicates chlamydial conjunctival and nasopharyngeal infection; and that topical sulfacetamide therapy may result in persistent conjunctival infection and nasopharyngeal colonization.

Administration, Oral↗
PubMed1983

Therapeutic doses of erythromycin esteolate is not cholestatic in rats in vivo.

The effect of erythromycin esteolate (EE) on bile flow and bile acid secretion was studied in male Wistar rats in vivo. Daily oral treatment with a dose of up to 100 mg/kg for 1 week increased the bile flow and the bile acid secretion. Increasing the days of treatment to 4 weeks with a dose of 20 mg/kg did not alter the measured parameters significantly. Acute intravenous injection of erythromycin lactobionate (50 mg/kg) also increased bile flow and biliary bile acid secretion temporarily. The increase in bile flow may partly be due to the osmotic effect of the drug and its metabolites in bile. Since EE failed to produce cholestasis in the range of therapeutic doses, rats do not seem to be a suitable experimental model for studying EE-cholestasis.

Animals↗
PubMed1987

Erythromycin ethyl succinate: diffusion through interstitial dermal fluid.

Erythromycin is widely used in dermatology. There are few studies of its diffusion in the skin. The diffusion of erythromycin ethyl succinate (EES) in dermal fluid has now been investigated by the suction blister method. Suction blister fluid (SBF) and blood samples were collected from 10 volunteers before administration of 1 g EES and 10 times during the following 24 h. The median peak serum level was 2.05 micrograms/ml and in SBF it was 0.34 microgram/ml. The median ratio of the areas under curves (f SBF/f serum) was 43%. In all subjects EES concentrations in SBF between the second and twelfth hours exceeded 0.1 g/ml. The results show good diffusion of EES through normal skin from the second to the twelfth hours after oral administration.

Adult↗
PubMed1979

Cholestatic and hepatocellular injury associated with erythromycin esters: report of nine cases.

A combined cholestatic and hepatocellular injury occurred in nine patients, following therapy with erythromycin estolate (EE) or other erythromycin derivatives. Eight of the nine patients developed jaundice within three weeks after initiation of treatment; pain was one of the main symptoms in five patients while fever and itching were noted in four patients. Symptoms and signs subsided and abnormal tests of liver function returned to normal after withdrawal of the drug. The major histologic finding was cholestasis, but the majority of cases also had evidence of hepatocellular injury of variable severity; one biopsy specimen showed centrilobular necrosis. Ultrastructural findings in one case included changes related to cholestasis as well as hepatocellular injury with striking mitochondrial abnormalities. Our data are compared with those of the literature, with special reference to morphologic features.

Adolescent↗