Erythromycin (Erycin)
What is Erythromycin
Erythromycin, sold under brand names such as Erycin, is a macrolide antibiotic used to treat a wide range of bacterial infections. It is effective against many respiratory tract infections, skin infections, ear infections, and certain sexually transmitted infections. Unlike antiviral or antifungal medications, Erythromycin specifically targets bacteria, stopping their growth and preventing them from spreading.
Erythromycin works by inhibiting bacterial protein synthesis. It binds to the 50S ribosomal subunit of bacteria, blocking the production of essential proteins. This action halts bacterial growth, allowing the immune system to clear the infection. Erythromycin is available in oral tablets, capsules, liquids, topical gels, and intravenous forms, making it versatile for different types of infections.
Recommendations
Erythromycin is prescribed in many situations where bacterial infection is suspected or confirmed. Common uses include:
• Respiratory tract infections (bronchitis, pneumonia, whooping cough);
• Skin and soft tissue infections (acne, impetigo, cellulitis);
• Ear infections (otitis media);
• Sexually transmitted infections (chlamydia, syphilis in certain cases);
• Strep throat or tonsillitis (in patients allergic to penicillin);
• Prophylaxis for rheumatic fever in patients with penicillin allergy.
The dosage and duration of treatment depend on the type of infection, patient’s age, and severity. For adults, Erythromycin is often prescribed at 250–500 mg every 6 hours, while children’s doses are based on body weight.
Precautions and Contraindications
Erythromycin is generally well tolerated, but certain conditions require caution. It should not be used in patients with:
• Known allergy to erythromycin or other macrolides;
• Severe liver disease (since the drug is metabolized in the liver);
• History of QT prolongation or certain irregular heart rhythms;
• Concurrent use of drugs known to cause dangerous heart rhythm disturbances.
Caution is needed in patients with myasthenia gravis, kidney impairment, or those taking multiple medications that affect the heart.
Interactions
Erythromycin has many potential drug interactions, the most important of which include the following:
• Other antibiotics (clarithromycin, azithromycin) - not usually combined;
• Statins (simvastatin, lovastatin) - increased risk of muscle damage (rhabdomyolysis);
• Warfarin - may increase bleeding risk;
• Theophylline - can raise blood levels, increasing side effects;
• Antiarrhythmic drugs (amiodarone, quinidine) - risk of severe heart rhythm disturbances;
• Ergot alkaloids - risk of ergot toxicity (should be avoided).
Always provide your doctor with a full list of medications and supplements before starting Erythromycin.
Side Effects
As with all antibiotics, some common side effects may occur:
• Nausea and vomiting;
• Abdominal pain or cramping;
• Diarrhea;
• Loss of appetite.
Less common but serious side effects:
• Severe allergic reactions (rash, swelling, difficulty breathing);
• Liver problems (yellowing of the skin/eyes, dark urine);
• Irregular heart rhythms or fainting;
• Severe diarrhea.
Patients should seek medical help if they develop persistent diarrhea, chest pain, or signs of liver damage.
Overdose
An overdose of Erythromycin can lead to significant health risks. Symptoms may include:
• Severe nausea and vomiting;
• Hearing loss (usually reversible);
• Irregular heartbeat;
• Confusion or fainting.
In the case of suspected overdose, emergency medical attention is required. Treatment is supportive and may include gastric lavage, monitoring of heart rhythm, and management of fluid and electrolyte balance.