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PubMedDate not supplied

Comparison of erythromycin ethylsuccinate and co-trimoxazole for treatment of pertussis.

Fifty-five ambulatory children with early culture-proven pertussis were treated for two weeks either with erythromycin ethylsuccinate (n = 28) (50-80 mg/kg/day in three doses during meals) or with co-trimoxazole (n = 27) (6-10 mg trimethoprim/kg/day in two doses after meals). After completion of treatment, all patients in the erythromycin group were culture-negative, while in the co-trimoxazole group one child was still culture-positive. In this case vomiting may have played a role. Both agents appear to be able to eradicate Bordetella pertussis from the nasopharynx of patients with early whooping cough.

Anti-Bacterial Agents↗
PubMed1984

Cholestatic hepatitis from erythromycin ethylsuccinate. Report of two cases.

Cholestatic hepatitis developed in two patients while they were receiving erythromycin ethylsuccinate. Both patients had received the drug without apparent problem within two months of the episode of drug-related cholestatic injury. In both, there was complete resolution of the hepatic injury upon withdrawal of the drug. Erythromycin ethylsuccinate should be added to the list of drugs causing cholestatic hepatitis.

Chemical and Drug Induced Liver Injury↗
PubMed1996

Selective spectrophotometric method for the determination of erythromycin and its esters in pharmaceutical formulations using gentiana violet.

A simple and selective method for the determination of erythromycin and its stearate and succinate esters in their pure forms and in pharmaceutical formulations is described. The procedure is based on the formation of a blue-coloured (lambda max = 633 nm) complex with gentiana violet in alkaline medium. Different variables affecting the colour development were studied and optimized. The method was used to determine 2.5-25 micrograms ml-1 of erythromycin in the final measured solution. The simplicity of the method permits rapid analysis and it is thus suitable for routine control. The method is highly specific for the determination of stearate and succinate esters in pharmaceutical formulations. The reliability of the method was established by parallel determinations against the official British Pharmacopoeial method.

Anti-Bacterial Agents↗
PubMedDate not supplied

Erythromycin failure in the treatment of syphilis in a pregnant woman.

A pregnant woman with a history of allergy to penicillin was diagnosed as having primary syphilis. Two successive courses of erythromycin therapy failed to cure the infection. Penicillin desensitization and therapy were initiated and were successful. The newborn was diagnosed as having probable congenital syphilis. This case emphasizes the need for close follow-up of pregnant women after erythromycin treatment for early syphilis.

Adult↗
PubMed1988

Prolonged cholestasis and disappearance of interlobular bile ducts following chlorpropamide and erythromycin ethylsuccinate. Case of drug interaction?

A 52-year-old man, having been treated for 4 months with chlorpropamide for diabetes mellitus type II, developed severe cholestatic hepatitis following a short course of erythromycin ethylsuccinate. Despite prompt withdrawal of both drugs, the cholestatic picture worsened and was associated with morphological evidence of disappearing interlobular bile ducts. After a 2-year course of profound cholestasis complicated by steatorrhea and striking hyperlipidemia, the patient died of ischemic cardiomyopathy. It is believed that this is the first published case of irreversible cholestasis with disappearance of ducts potentially related to a metabolic interaction between erythromycin ethylsuccinate and chlorpropamide.

Bile Ducts, Intrahepatic↗
PubMed1964

ACTION OF ERYTHROMYCIN ON "PROTOPLASTS" IN VIVO.

Bacteria may persist in "protoplast" form in kidneys after treatment of experimental enterococcal pyelonephritis with penicillin. Erythromycin, while ineffective against the bacterial form of infection, was able to kill "protoplasts" in vivo. This finding is consistent with the hypothesis that intact cell wall interferes with the ingress of erythromycin into the cellular area in which it acts.

Bacteriological Techniques↗
PubMed1986

Campylobacter pyloridis and associated gastritis: investigator blind, placebo controlled trial of bismuth salicylate and erythromycin ethylsuccinate.

An investigator blind trial was performed comparing bismuth salicylate, erythromycin ethylsuccinate, and placebo in the treatment of Campylobacter pyloridis associated gastritis in patients without peptic ulceration. Fifty patients fulfilled the study criteria. There was a strong correlation between the presence of C pyloridis and histologically confirmed gastritis. Clearance of organisms led to improvement of the gastritis. C pyloridis was cleared from 15 patients; of these, 13 had gastritis initially, which resolved in 12. Conversely, gastritis resolved in only four of 32 patients not cleared of organisms (p less than 0.0001). There was significantly greater improvement in endoscopic appearances in the patients cleared of C pyloridis compared with those whose infection persisted (p less than 0.001). In the three treatment groups organisms were cleared from 14 of 18 patients receiving the locally active bismuth salicylate, only one of 15 patients receiving erythromycin ethylsuccinate, and none of 17 patients taking placebo. These findings suggest that the ideal antimicrobial for the successful eradication of C pyloridis associated gastritis should be locally active, stable at low pH, and should penetrate gastric mucus. The resolution of gastritis and improvement in endoscopic appearances associated with clearance of C pyloridis support the view that these organisms may play a part in this condition.

Adult↗
PubMed1975

Comparison of erythromycin ethyl succinate, stearate and estolate treatments of group A streptococcal infections of the upper respiratory tract.

The microbiologic and clinical responses of acute Group A beta-hemolytic streptococcal infections of the upper respiratory tract to oral treatment with erythromycin ethyl succinate, stearate, and estolate were studied in 303 patients. Streptococcal M and T typing was done on all positive cultures. The overall cure rate was 95.4 per cent, with no statistically significant differences in clearing organisms from the pharynx. Of the 285 cured patients who completed the prescribed follow-up period, 11 had recurrences between the 12th and 31st day after initiation of therapy, and five developed new infections. No cases of rheumatic fever or glomerulonephritis were encountered during a follow-up study. Eight gastrointestinal reactions and one transient rash occurred. Results with these forms of erythromycin compare favorably with published results for similar infections treated with oral penicillins.

Administration, Oral↗
PubMed1987

Gastrointestinal side effects with erythromycin preparations.

This study was designed to determine the incidence and severity of gastrointestinal (GI) side effects in patients taking erythromycin. More patients complained of GI side effects with the enteric-coated tablet (70.8 percent) than with the stearate (51.4 percent) or the ethylsuccinate (48.9 percent) salts. The enteric-coated tablet was associated with a higher incidence of individual adverse reactions; more patients discontinued it because of adverse GI effects. These data demonstrate a high incidence of GI side effects to erythromycin. Additionally, GI side-effect incidence appears to be higher with the enteric-coated tablet.

Adolescent↗
PubMedDate not supplied

The effect of erythromycin on the nasopharyngeal pathogens in children with secretory otitis media.

Seventy-five children not older than 11 years, with secretory otitis media of more than 3 months' duration were randomly divided into two groups prior to myringotomy. One group remained untreated, whereas the other received erythromycin ethylsuccinate (Abboticin) in standard dosage for the last 10 days before surgery. Nasopharyngeal cultures were taken under general anaesthesia, which ensured an uniform mode of sampling. In the erythromycin-treated group the occurrence of Streptococcus pneumoniae (3%) and Branhamella catarrhalis (0%) was significantly lower than in the control group (35% and 32%, respectively); and the frequency of cultures with no pathogen was significantly higher in the treated group. The occurrence of Haemophilus influenzae remained essentially unchanged.

Bacteria↗
PubMedDate not supplied

Effect of erythromycin on adenoid bacteria.

Seventy-eight patients with secretory otitis media were given erythromycin ethylsuccinate 50 mg/kg/day, divided into 2 doses, for 7-8 days before undergoing adenoidectomy and tympanostomy. Nasopharyngeal swabs for bacterial culture were obtained before medication and at surgery and the adenoid homogenate was also studied for bacteria. Pneumococci and Branhamella strains became significantly reduced, while Hemophilus influenzae showed no change. Pneumococcus and Branhamella strains partially returned one month after surgery and in part were found in patients who had not had these strains before antimicrobial therapy. Erythromycin ethylsuccinate can sterilize neither the adenoids nor the middle ear space if the causative agent is Hemophilus influenzae.

Adenoidectomy↗
PubMed1990

Influence of alcohol consumption on erythromycin ethylsuccinate kinetics.

The effect of ethyl alcohol ingestion on erythromycin kinetics was studied. Nine healthy volunteers, four males and five females, participated in the study. They received, in two separate occasions, 500 mg of erythromycin ethylsuccinate ester given with water or with an alcoholic beverage. The antibiotic was assayed in plasma, using a microbiological method. Absorption and disposition parameters were calculated according to classical pharmacokinetic techniques. A longer lag time and a decrease in AUC were observed when the antibiotic was given with alcohol. The differences were statistically significant. It is likely that the effect of alcohol on gastric emptying could be responsible for the delayed absorption of the antibiotic.

Adult↗
PubMed1982

Trachoma therapy with topical tetracycline and oral erythromycin: a comparative trial.

Because topical antibiotic treatment has had a limited effect in previous controlled trials against trachoma, treatment with oral erythromycin was compared with topical tetracycline in 6-8-year-old children in southern Tunisia who had potentially blinding active trachoma. A total of 169 children were divided into two groups that were carefully matched for age, sex, locality, and intensity of disease. Oral erythromycin ethyl succinate in a paediatric dosage form was administered to one group and topical 1% tetracycline ointment to the other group, twice daily, six days a week for three weeks. The two treatments were equivalent in effectiveness and resulted in a substantial decrease in disease intensity and a marked reduction in chlamydial infection detected in conjunctival smears. To maintain blood levels of antibiotics known to be effective in the treatment of chlamydial infections with a dosage schedule possible in a trachoma control programme, one of the long-acting tetracyclines (doxycycline or minocycline) might be considered. Such systemic chemotherapy should be limited to selective treatment of individuals who can be adequately monitored.

Administration, Oral↗
PubMed1985

Carbamazepine toxicity induced by concurrent erythromycin therapy.

We describe a 41-year-old woman receiving carbamazepine for epilepsy, in whom concurrent erythromycin stearate administration led to carbamazepine toxicity, including inappropriate antidiuretic hormone syndrome. We review the literature on erythromycin-carbamazepine interaction and discuss the mechanism for such interaction.

Adult↗
PubMed1978

Transport of antibiotics into the canine sinus. Experiments with penicillin G and erythromycin.

Complete and consistent occlusion of the nasofrontal duct of the canine sinus was achieved by introducing acrylic through a trephinated opening in the nasal dorsum. This surgical procedure resulted in the isolation of the frontal sinus, without impairing the integrity of the cavity. In this experimental canine model, potassium penicillin G and erythromycin lactobionate were absorbed into the blood equally well when placement was either in the intramuscular (IM) space or in frontal sinus cavity. When different concentrations of these antibiotics were injected into the IM space, peak blood levels occurred between one and two hours; however, peak sinus levels, following IM introduction, did not occur until four hours. The peak ratios show that between 4% and 20% of penicillin, and 1% and 12% of erythromycin in the blood is transferred across the normal sinus membrane.

Absorption↗
PubMed1984

Ototoxic effect of erythromycin therapy.

Thirty-two cases of sudden, symmetrical, high-frequency, sensorineural hearing loss associated with intravenous (IV) and oral erythromycin therapy have been published since 1973. We treated a patient with reversible ototoxicity associated with IV erythromycin for the treatment of legionnaire's disease.

Audiometry↗
PubMed1999

Structural elucidation studies of erythromycins by electrospray tandem mass spectrometry II.

Erythromycin A (EryA), sec-butyl erythromycin B (SEryB), oleandomycin (Olean) and a synthetic derivative, roxithromycin (Rox), were used to investigate the fragmentation of polyketide macrolide antibiotics by collision induced dissociation (CID) tandem mass spectrometry (MS/MS). Analyses were performed with two commercially available mass spectrometers: a Q-TOF hybrid quadrupole time-of-flight instrument and a BioApex II (4.7 Tesla) Fourier transform ion cyclotron resonance (FTICR) instrument both equipped with electrospray ionisation (ESI) sources. One of the first fragmentation processes is the loss of an H(2)O molecule from the [M+H](+) ion. EryA has three hydroxyl groups on the polyketide ring and loses three H(2)O molecules during CID. This study indicates that these facts are not necessarily related. Deuterium exchange experiments were carried out in order to isotopically label free hydroxyl groups. (18)O-exchange experiments were also carried out in order to label the carbonyl group at the 9-position. In EryA and its analogue the first H(2)O loss shifts in mass from loss of 18 Da to loss of 20 Da in deuterated solvents. For both molecules the loss also shifts in mass from loss of 18 Da to loss of 20 Da during the (18)O-exchange experiments. This suggests that the first loss of H(2)O is from the 9-position carbonyl group, indicating that this, and not the nitrogen of the amino sugar, is the site of protonation of the activated MH(+) ions. For Rox the initial loss of H(2)O is replaced by loss of the 9-position oxime group, the rest of the fragmentation sequence being the same as for EryA. For Olean, there is no H(2)O loss from the parent ion. The results have allowed the proposal of a mechanism for the first loss of H(2)O in the EryA MS/MS fragmentation.

Anti-Bacterial Agents↗
PubMed2000

Analysis of a commercial preparation of erythromycin estolates by tandem mass spectrometry and high performance liquid chromatography/electrospray ionization tandem mass spectrometry using an ion trap mass spectrometer.

Because of the lack of a UV chromophore and their much smaller abundances in comparison with the major component, the minor components in erythromycin estolate preparations are difficult to analyze by high performance liquid chromatography ultraviolet (HPLC-UV). Tentative assignment of the major and minor components can be achieved with the combination of full scan and ZoomScan using an ion trap mass spectrometer. Tandem mass spectrometry (MS/MS) provided an effective method to quickly identify most components without chromatographic separation, and all the related compounds, except the isobaric pair ECE and PdMeEA, could be identified in this way. The best result was obtained by using liquid chromatography/tandem mass spectrometry (LC/MS/MS) operated in selected reaction monitoring mode. The major compound, the estolate of erythromycin A (EAE), and seven other minor components, could be separated and identified, with semiquantitative estimates of relative concentrations.

Anti-Bacterial Agents↗