Drug Index


Mechanism :

Erythromycin is a macrolide antibiotic. It is bacteriostatic against most gram-positive and gram-negative organisms and used in the treatment of infections caused by chlamydia, mycoplasma, urea plasma, spirochetes and rickettsia. It is used as a prophylactic agent against ophthalmia neonatorum and pertussis.

Indication :

  • Pertussis
  • Penicillin allergic rheumatic fever prophylaxis
  • Campylobacter infection
  • Uncomplicated genital infections
  • Yersinia pseudo tuberculosis infections
  • Mycoplasma pneumonia
  • GI dysmotility

Contraindications :

Contraindicated in patients with known hypersensitivity to erythromycin, or any other macrolide. Erythromycin is contraindicated in patients taking terfenadine, astemizole, or cisapride. Concurrent topical acne therapy should be used with caution as irritation can occur.

Dosing :

30-50 mg/kg/day orally in 3-4 divided doses; Max: 4 g/day for one to two weeks.
GI dysmotility:
10-20 mg/kg/day in 3-4 divided doses.

Adverse Effect :

Vomiting, nausea, diarrhea, abdominal pain, anorexia, hepatic dysfunction, ventricular arrhythmias (tachycardia, torsades de pointes, in patients with prolonged QT intervals), chest pain, dizziness, palpitations.

Interaction :

Theophylline: Increase in serum theophylline levels and potential theophylline toxicity.
Oral anticoagulants: Increased anticoagulant effects.
Benzodiazepines: Increase the pharmacologic effects.
Carbamazepine, Cyclosporine, Tacrolimus, Hexobarbital, Phenytoin, Alfentanil, Cisapride, Disopyramide, Lovastatin, Bromocriptine, Valproate, Terfenadine, and Astemizole: Increased serum levels.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<1050–75 % of normal dose; maximum 2 g daily

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. Dose as in GFR<10 mL/min
HDNot dialysed. Dose as in GFR<10 mL/min
HDF/High fluxUnknown dialysability. Dose as in GFR<10 mL/min
CAV/VVHDUnknown dialysability. Dose as in normal renal function

Hepatic Dose :

Erythromycin should be used with caution in patients with impaired hepatic function. Although specific dosage guidelines are not available, a reduced dosage may be necessary.
03/24/2024 12:10:44 Erythromycin
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