Erythromycin / Sulfisoxazole Dosage

Applies to the following strengths: 200 mg-600 mg/5 mL

Usual Adult Dose for Otitis Media

50 mg/kg/day orally (based on the erythromycin component) divided into 3 or 4 equal doses for 10 days (unlabelled use).

Usual Pediatric Dose for Otitis Media

>=2 months to 18 years: 50 mg/kg/day orally (based on the erythromycin component) divided into 3 or 4 equal doses for 10 days.

Renal Dose Adjustments

Sulfonamides should be given with caution to patients with renal impairment.

Liver Dose Adjustments

Erythromycin-sulfisoxazole should be given with caution to patients with hepatic impairment.

Precautions

Sulfonamides may cause kernicterus in neonates and are contraindicated in infants <2 months old, in pregnant women at term, and in mothers who are nursing infants <2 months old.

Fatalities associated with the administration of sulfonamides, although rare, have occurred due to severe reactions including Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anemia, and other blood dyscrasias. Sulfonamides should be discontinued at the first appearance of skin rash or any sign of adverse reaction.

Sulfonamides may cause dose-related hemolysis in patients with glucose-6-phosphate dehydrogenase deficiency.

Erythromycin may interact with other drugs and concurrent use with numerous other drugs is either contraindicated, not recommended, or requires additional monitoring. Patients should be advised to report all prescription and nonprescription drugs that they are currently taking to their healthcare providers.

Erythromycin is considered unsafe for use in patients with porphyria.

Dialysis

Sulfonamides should be given with caution to patients with renal impairment.

Other Comments

Adequate fluid intake is recommended to prevent crystalluria and kidney stone formation.

The maximum daily dose is 2 g erythromycin or 6 g sulfisoxazole.

The reconstituted suspension should be stored in the refrigerator, shaken well before use, and any unused portion should be discarded after 14 days.