Skip to Content
Print Share

Erythromycin (Systemic)

Class: Erythromycins
VA Class: AM200
CAS Number: 114-07-8
Brands: E.E.S., ERYC, EryPed, Ery-Tab, Erythrocin, PCE

Medically reviewed by Drugs.com. Last updated on June 22, 2020.

Introduction

Antibacterial; macrolide antibiotic produced by Saccharopolyspora erythraeus.263 268 f

Uses for Erythromycin (Systemic)

Acute Otitis Media (AOM)

Treatment of AOM in children caused by susceptible Haemophilus influenzae.264 The fixed-combination preparation containing erythromycin ethylsuccinate and sulfisoxazole acetyl must be used;264 erythromycin is not effective when used alone for treatment of H. influenzae infections.264 c

The fixed-combination preparation containing erythromycin ethylsuccinate and sulfisoxazole acetyl is an alternative (not a preferred agent) for treatment of AOM.311 483 The drug is recommended as an alternative in patients with type I penicillin hypersensitivity.311 May not be effective for treatment of AOM that fails to respond to amoxicillin since a high incidence of S. pneumoniae resistant to the fixed-combination drug has been reported.483

Pharyngitis and Tonsillitis

Treatment of pharyngitis and tonsillitis caused by S. pyogenes (group A β-hemolytic streptococci).242 262 263 268 311 392 441 472 f Generally effective in eradicating S. pyogenes from the nasopharynx, but efficacy in prevention of subsequent rheumatic fever has not been established to date.a

CDC, AAP, IDSA, AHA, and others recommend oral penicillin V or IM penicillin G benzathine as treatments of choice;243 311 392 441 472 oral cephalosporins and oral macrolides considered alternatives.311 392 441 472 Amoxicillin sometimes used instead of penicillin V, especially for young children.441

Erythromycin usually the preferred alternative for treatment of streptococcal pharyngitis in patients hypersensitive to penicillin.243 311 392 441 Although S. pyogenes resistant to erythromycin and other macrolides have been reported and may be prevalent in some areas of the world (e.g., Japan, Finland), the incidence of these resistant S. pyogenes in the US has been relatively low to date.311 392 441 446

Respiratory Tract Infections

Treatment of respiratory tract infections caused by susceptible S. pneumoniae.263 268 f 268 269 270 f

Treatment of respiratory tract infections caused by Mycoplasma pneumoniae or C. pneumoniae.263 268 f 268 a c f

Erythromycin usually not effective when used alone for treatment of respiratory tract infections caused by H. influenzae.242 262 269 c f

Skin and Skin StructureInfections

Treatment of mild to moderate skin and skin structure infections caused by S. pyogenes or Staphylococcus aureus.263 268 f 268 a b c f Consider that erythromycin-resistant Staphylococci may develop during treatment.263 268 f a b c f

Treatment of erythrasma caused by Corynbacterium minutissimum.263 268 f 268 b c f

Acne

Treatment of acne†.459

Amebiasis

Has been used for treatment of intestinal amebiasis caused by Entamoeba histolytica.242 262 263 268 f Erythromycin generally not recommended for treatment of amebiasis; regimen of choice for intestinal amebiasis is metronidazole or tinidazole followed by a luminal amebicide such as iodoquinol or paromomycin.259 311

Anthrax

Alternative for treatment of anthrax†.218 227 472

Multiple-drug parenteral regimens recommended for treatment of inhalational anthrax that occurs as the result of exposure to B. anthracis spores in the context of biologic warfare or bioterrorism.216 347 Initiate treatment with IV ciprofloxacin or doxycycline and 1 or 2 other anti-infective agents predicted to be effective (e.g., chloramphenicol, clindamycin, rifampin, vancomycin, clarithromycin, imipenem, penicillin, ampicillin);216 347 if meningitis is established or suspected, use IV ciprofloxacin (rather than doxycycline) and chloramphenicol, rifampin, or penicillin.216

Bartonella Infections

Has been used in conjunction with IM or IV ceftriaxone for treatment of bacteremia caused by Bartonella quintana† (formerly Rochalimaea quintana).460

Optimum regimens for treatment of infections caused by B. quintana or for treatment of cat scratch disease or other B. henselae infections have not been identified.460 462 463

USPHS/IDSA suggests that long-term suppression with erythromycin or doxycycline be considered to prevent recurrence of Bartonella infection in HIV-infected patients†.420

Campylobacter Infections

Treatment of symptomatic enteric infections caused by Campylobacter jejuni†. Recommended by CDC,272 IDSA,271 and AAP311 as a treatment of choice.

Chancroid

Treatment of chancroid† (genital ulcers caused by H. ducreyi).228 248 472

CDC and others recommend azithromycin, ceftriaxone, ciprofloxacin or erythromycin as drugs of choice for treatment of chancroid.228 248 472 HIV-infected patients and uncircumcised patients may not respond to treatment as well as those who are HIV-negative or circumcised.228 248 472 Some experts prefer the 7-day erythromycin regimen instead of single-dose azithromycin or ceftriaxone regimens in HIV-infected individuals.228

Chlamydial Infections

Alternative for treatment of uncomplicated urethral, endocervical, or rectal infections caused by Chlamydia trachomatis when tetracyclines and azithromycin are contraindicated or not tolerated.228 248 f Erythromycin is less effective than either azithromycin or doxycycline and GI effects associated with the drug may discourage patient compliance with the regimen;228 CDC recommends that the first dose be taken under supervision.228

A drug of choice for treatment of urogenital chlamydial infections in pregnant women and in young children.228

Alternative for presumptive treatment of coexisting chlamydial infections in patients receiving treatment for gonorrhea.228 311 Preferred drugs are azithromycin or doxycycline;228 erythromycin may be preferred in young children.311

Treatment of urethritis caused by Ureaplasma urealyticum.f

Treatment of chlamydial pneumonia in infants.f 248

Treatment of initial episodes and recurrences of chlamydial conjunctivitis in neonates.228 248 311 f

Alternative to doxycycline for treatment of lymphogranuloma venereum† caused by invasive serotypes of C. trachomatis (serovars L1, L2, L3).228 248 311 Erythromycin may be the preferred regimen for pregnant and lactating women.228

Alternative for treatment of psittacosis when tetracyclines are contraindicated (e.g., in pregnant women, children younger than 9 years of age).311 451

Diphtheria

Adjunct to diphtheria antitoxin for treatment of diphtheria caused by Corynebacterium diphtheria.261 263 268 311 454 455 474 c f Diphtheria antitoxin is the most important aspect of treatment of respiratory diphtheria.261 311 454 455 Anti-infectives may eliminate C. diphtheriae from infected sites, prevent spread of the organism and further toxin production, and prevent or terminate the diphtheria carrier state, but appear to be of no value in neutralizing diphtheria toxin and should not be considered a substitute for antitoxin therapy.311 454 455

Because diphtheria infection often does not confer immunity, active immunization with a diphtheria toxoid preparation should be initiated or completed during convalescence.311 455

Prevention of diphtheria in close contacts of patients with diphtheria.261 263 311 455 Prophylaxis is indicated in all household or other close contacts of individuals with suspected or proven diphtheria, regardless of vaccination status; prophylaxis should be initiated promptly and should not be delayed pending culture results.311 454 455 An age-appropriate diphtheria toxoid preparation also may be necessary depending on immunization status.261 311

Elimination of diphtheria carrier state in individuals known to carry toxigenic strains of C. diphtheriae.261 311 454 455

Granuloma Inguinale (Donovanosis)

Alternative for treatment of granuloma inguinale† (donovanosis) caused by Calymmatobacterium granulomatis.228 450

CDC recommends doxycycline or co-trimoxazole as drugs of choice; ciprofloxacin, erythromycin, and azithromycin are alternatives.228 Erythromycin may be preferred in pregnant and lactating women.228

Legionnaires’ Disease

Treatment of Legionnaires’ disease caused by Legionella pneumophila; used with or without rifampin.242 262 263 268 270 311 452 453 472 c f

Lyme Disease

Alternative for treatment of early Lyme disease†.214 310 311 394 395 397 399 472 473 476 477 478 IDSA, AAP, and others recommend doxycycline, amoxicillin, or cefuroxime as first-line agents; macrolides may be less effective.214 265 267 274 331 472 475

Nongonococcal Urethritis

Treatment of nongonococcal urethritis (NGU).228 242 248 262 263

CDC and others recommend azithromycin or doxycycline as drugs of choice for treatment of NGU;228 248 erythromycin (erythromycin base or ethylsuccinate) or fluoroquinolones (levofloxacin, ofloxacin) are alternatives.228 248 A regimen of erythromycin and metronidazole is recommended by CDC for treatment of recurrent and persistent urethritis in patients who were compliant with their initial regimen and have not been re-exposed.228

Pelvic Inflammatory Disease (PID)

IV erythromycin lactobionate followed by oral erythromycin has been used for treatment of PID) caused by N. gonorrhoeae,242 262 263 c f but erythromycins are not included in current CDC recommendations for treatment of PID.228

Pertussis

Treatment of Bordetella pertussis infection (pertussis, whooping cough);268 253 261 311 455 457 472 f a drug of choice.253 261 311 455 457 472

Prevention of pertussis in contacts of patients with the disease;253 261 268 311 455 457 472 f drug of choice.253 261 311 455 457 472

CDC, AAP, and other clinicians recommend anti-infective prophylaxis for all household and other close contacts (e.g., those in childcare) of individuals with pertussis, regardless of age or vaccination status.261 311 455 456 Close contacts <7 years of age who are not fully immunized against pertussis also should receive the remaining required doses of a preparation containing pertussis vaccine (using minimal intervals between doses) and those who are fully immunized but have not received a vaccine dose within the last 3 years should receive a booster dose of a pertussis vaccine preparation.261

Syphilis

Has been used as an alternative for treatment of primary syphilis in penicillin-allergic individuals.262 263 268 f

Penicillin G is drug of choice for treatment of all stages of syphilis.228 248 Erythromycin is less effective than other possible penicillin alternatives275 and is not included in CDC recommendations for treatment of any form of syphilis in adults or adolescents (including primary, secondary, latent, or tertiary syphilis or neurosyphilis).228

Preoperative Intestinal Antisepsis

Adjunct to mechanical cleansing of the large intestine for intestinal antisepsis prior to elective colorectal surgery; used in conjunction with neomycin.237 262

Prevention of Bacterial Endocarditis

Has been used as an alternative to penicillins for prevention of bacterial endocarditis in penicillin-allergic patients undergoing certain dental, oral, respiratory tract, or esophageal procedures who have cardiac conditions that put them at high or moderate risk.302 AHA no longer recommends erythromycin for this use, but states that practitioners who have successfully used an erythromycin (i.e., erythromycin ethylsuccinate, erythromycin stearate) for prophylaxis in individual patients may choose to continue using these agents.436

Erythromycins are not appropriate for prevention of bacterial endocarditis in patients undergoing GI, biliary, or genitourinary tract procedures because causative organisms are likely to be erythromycin-resistant.436

Consult most recent AHA recommendations for specific information on which cardiac conditions are associated with high or moderate risk of endocarditis and which procedures require prophylaxis.436

Prevention of Rheumatic Fever Recurrence

Alternative to IM penicillin G benzathine, oral penicillin V potassium, and oral sulfadiazine for prevention of recurrence of rheumatic fever (secondary prophylaxis) in patients hypersensitive to penicillins and sulfonamides.311 392 c f

Continuous prophylaxis recommended following treatment of documented rheumatic fever (even if manifested solely by Sydenham chorea) and in those with evidence of rheumatic heart disease.311 392

Prevention of Perinatal Group B Streptococcal Disease

Alternative to penicillin G or ampicillin for prevention of perinatal group B streptococcal (GBS) disease† in penicillin-allergic pregnant women at risk for anaphylaxis with a β-lactam anti-infective.246 311 415

Intrapartum anti-infective prophylaxis to prevent early-onset neonatal GBS disease is administered to women identified as GBS carriers during routine prenatal GBS screening performed at 35–37 weeks during the current pregnancy and to women who have GBS bacteriuria during the current pregnancy, a previous infant with invasive GBS disease, unknown GBS status with delivery at <37 weeks gestation, amniotic membrane rupture for ≥18 hours, or intrapartum temperature of ≥38°C.246 415

Penicillin G is the regimen of choice and ampicillin is the preferred alternative.246 415 Cefazolin can be used in penicillin-allergic women who do not have immediate-type penicillin hypersensitivity, but clindamycin or erythromycin should be used in penicillin-allergic women at high risk for anaphylaxis.415

Consider that S. agalactiae (group B streptococci) with in vitro resistance to clindamycin and erythromycin has been reported with increasing frequency;415 perform in vitro susceptibility tests of clinical isolates obtained during GBS prenatal screening.415 GBS resistant to erythromycin often are resistant to clindamycin, although this may not be evident in results of in vitro testing.415 If in vitro susceptibility testing is not possible, results are unknown, or isolates are found to be resistant to erythromycin or clindamycin, vancomycin is recommended for intrapartum prophylaxis in penicillin-allergic women at high risk for anaphylaxis with β-lactams.415

Erythromycin (Systemic) Dosage and Administration

Administration

Administer orally as erythromycin base, stearate, ethylsuccinate, or estolate.a Administer erythromycin lactobionate by IV infusion.c

Oral route usually preferred and should replace parenteral route as soon as possible.a

Oral Administration

Erthromycin delayed-release tablets (PCE Dispertab, Ery-Tab) may be given without regard to meals,262 b but optimal absorption of PCE Dispertab occurs when the tablets are given in the fasting state (at least 30 minutes and, preferably, 2 hours before meals).b Erythromycin film-coated tablets should be administered in the fasting state (at least 30 minutes and, preferably, 2 hours before or after meals).d e

Erythromycin delayed-release capsules containing enteric-coated pellets of erythromycin (ERYC) may be swallowed intact or the entire contents of a capsule(s) may be sprinkled on a small amount of applesauce immediately prior to administration; subdividing the contents of a capsule is not recommended.h The enteric-coated pellets contained in the capsules should not be chewed or crushed.h If the capsule contents are administered by sprinkling on applesauce, the patient should drink some water after swallowing the applesauce to ensure that the pellets are swallowed.h If the pellets are accidentally spilled, the dose preparation should be started over with a new capsule.h

Erythromycin ethylsuccinate oral suspensions,268 f chewable tablets,f and film-coated tablets268 f (E.E.S., EryPed) are given without regard to meals. Chewable tablets should not be swallowed whole.f

Erythromycin stearate preferably should be administered in the fasting state or immediately before a meal.263

Fixed-combination preparation containing erythromycin ethylsuccinate and sulfisoxazole acetyl is given without regard to meals.264

Reconstitution

Reconstitute erythromycin ethylsuccinate powders for oral suspension with water according to manufacturers’ directions.268 f

IV Infusion

Administer erythromycin lactobionate by continuous or intermittent IV infusion.c Do not administer by rapid or direct IV injection because of the local irritative effects of the drug.c

Continuous IV infusion usually is preferred, but the drug may be administered by intermittent IV infusion every 6 hours.c

Reconstitution

Reconstitute ADD-Vantage vials according to the manufacturer’s instructions using 0.9% sodium chloride or 5% dextrose injection.c The ADD-Vantage vials are for single use only.c

Rate of Administration

For intermittent IV infusion; one-fourth of the total daily dose is administered over 20–60 minutes at intervals no longer than every 6 hours.c

Dosage

Available as erythromycin base, estolate, ethylsuccinate, stearate, or lactobionate; dosage expressed in terms of erythromycin.a Dosage of the fixed-combination preparation containing erythromycin ethylsuccinate and sulfisoxazole acetyl is expressed in terms of the erythromycin or sulfisoxazole content.264

Erythromycin ethylsuccinate has different absorption characteristics than other commercially available forms of oral erythromycin and higher doses of the ethylsuccinate may be needed to achieve therapeutic effects.268 f For adults, 400 mg of erythromycin as the ethylsuccinate provides erythromycin activity similar to that provided by 250 mg of erythromycin as the base, estolate, or stearate.268 f

Pediatric Patients

General Pediatric Dosage
Treatment of Infections
Oral

Erythromycin (base, estolate, ethylsuccinate, or stearate): 30–50 mg/kg daily in 2–4 equally divided doses.242 262 263 268 311 b d e f i

Dosage may be doubled for severe infections.242 262 268 311 b d e f

IV

Erythromycin (lactobionate): 15–20 mg/kg daily.c Dosage up to 4 g daily may be used for severe infections.c

Acute Otitis Media (AOM)
Oral

Children ≥2 months of age (fixed combination containing erythromycin ethylsuccinate and sulfisoxazole acetyl): 12.5 mg/kg (based on erythromycin content) every 6 hours or 17 mg/kg (based on erythromycin content) every 8 hours (up to 2 g daily).264 Alternatively, the following approximate dosages expressed in terms of volumes of the fixed-combination suspension can be used.264 (See Table 1 and Table 2.)

Pediazole Dosage (6-Hour Dosing) for AOM in Children ≥2 Months of Age

Weight (in kg)

Dose (repeated every 6 h for 10 days)

<8

Calculate dose by body weight

8–15.9

2.5 mL

16–23.9

5 mL

24–31.9

7.5 mL

>32

10 mL
Pediazole Dosage (8-Hour Dosing) for AOM in Children ≥2 Months of Age

Weight (in kg)

Dose (repeated every 8 h for 10 days)

<6

Calculate dose by body weight

6–11.9

2.5 mL

12–17.9

5 mL

18–23.9

7.5 mL

24–30

10 mL

>30

12.5 mL
Amebiasis
Entamoeba histolytica Infections
Oral

Erythromycin (base, estolate, ethylsuccinate, or stearate): 30–50 mg/kg daily in divided doses for 10–14 days.242 262 268 d e f

Anthrax†
IV

Erythromycin (lactobionate): 20–40 mg/kg daily given in divided doses every 6 hours.218

Must be used in multiple-drug regimens that initially include IV ciprofloxacin or IV doxycycline and 1 or 2 other anti-infectives predicted to be effective.216 347

Duration of treatment is 60 days if anthrax occurred as the result of exposure to anthrax spores in the context of biologic warfare or bioterrorism.216 347

Chlamydial Infections
Uncomplicated Urethral, Endocervical, or Rectal Infections in Children Weighing <45 kg
Oral

Erythromycin (base or ethylsuccinate): 50 mg/kg daily (maximum 2 g daily) given in 4 divided doses for 14 days.228

Uncomplicated Urethral, Endocervical, or Rectal Infections in Adolescents
Oral

Erythromycin (base or stearate): 500 mg 4 times daily for 7 days.228 242 248 262 311 d e Alternatively, 666 mg every 8 hours for 7 days.242 262

Erythromycin (ethylsuccinate): 800 mg 4 times daily for 7 days.228

Presumptive Treatment of Chlamydial Infections in Children Weighing <45 kg with Gonorrhea
Oral

Erythromycin (base or ethylsuccinate): 50 mg/kg daily (maximum 2 g daily) given in 4 divided doses for 7 days.228 311

Presumptive Treatment of Chlamydial Infections in Adolescents with Gonorrhea
Oral

Erythromycin (base): 500 mg 4 times daily for 7 days.228

Erythromycin (ethylsuccinate): 800 mg 4 times daily for 7 days.228

Treatment of Pneumonia Caused by C. trachomatis
Oral

Erythromycin (base, ethylsuccinate, or stearate): 50 mg/kg daily given in 4 divided doses for ≥14 days.228 248 262 263 311 Follow-up is recommended and a second course of therapy may be necessary.228 311

Treatment of Ophthalmia Neonatorum Caused by C. trachomatis
Oral

Erythromycin (base, ethylsuccinate, or stearate): 50 mg/kg daily given in 4 divided doses for 14 days.228 248 263 311 Follow-up is recommended and a second course of therapy may be necessary.228 311

Diphtheria
Treatment of Diphtheria
Oral

Erythromycin: 40–50 mg/kg daily (maximum 2 g daily) for 14 days.261 311 Patients usually are no longer contagious 48 hours after initiation of anti-infective therapy.261 Eradication of the organism should be confirmed by 2 consecutive negative cultures following completion of therapy.261 311

Prevention of Diphtheria
Oral

Erythromycin: 40–50 mg/kg daily (maximum 2 g daily) for 7–10 days.261 311 455

Elimination of Diphtheria Carrier State
Oral

Erythromycin: 40–50 mg/kg daily (maximum 2 g daily) for 7–10 days.311 455 Obtain follow-up cultures ≥2 weeks after completion of therapy; if cultures are positive, an additional 10-day course should be given and additional follow-up cultures obtained.311 455

Lyme Disease†
Early Localized or Early Disseminated Lyme Disease†
Oral

Erythromycin: 12.5 mg/kg (up to 500 mg) 4 times daily for 14–21 days.214 Alternatively, 30 mg/kg daily in 3 divided doses (or 250 mg 3 times daily) for 14–21 days.274

Nongonococcal Urethritis in Adolescents
Oral

Erythromycin (base): 500 mg 4 times daily for 7 days.228 Alternatively, 666 mg every 8 hours for ≥7 days.242 262 For recurrent and persistent urethritis, CDC recommends 500 mg 4 times daily for 7 days in conjunction with a single dose of oral metronidazole (2 g).228

Erythromycin (ethylsuccinate): 800 mg 4 times daily for 7 days.228 268 f For recurrent and persistent urethritis, CDC recommends 800 mg 4 times daily for 7 days in conjunction with a single dose of oral metronidazole (2 g).228

Pertussis
Treatment or Prevention of Pertussis
Oral

Erthromycin (base or stearate): 40–50 mg/kg daily (maximum 2 g daily) in divided doses for 14 days.263 311 455

Prevention of Bacterial Endocarditis†
Patients Undergoing Certain Dental, Oral, Respiratory Tract, or Esophageal Procedures†
Oral

Erythromycin (ethylsuccinate): 20 mg/kg 2 hours before the procedure and 10 mg/kg 6 hours later.302

Erythromycin (stearate): 20 mg/kg 2 hours before the procedure and 10 mg/kg 6 hours later.302

Adults

General Adult Dosage
Treatment of Infections
Oral

Erythromycin (base): 250 mg every 6 hours,262 d e 333 mg every 8 hours,242 262 d or 500 mg every 12 hours.242 262 d e In severe infections, dosage may be increased up to 4 g daily; however, a twice-daily dosing schedule is not recommended when dosages exceeding 1 g daily are administered.242 262 e

Erythromycin (estolate): 250 mg every 6 hours.i In severe infections, dosage may be increased up to 4 g daily.i

Erythromycin (ethylsuccinate): 400 mg every 6 hours.268 f Dosage up to 4 g daily may be used for severe infections.268 f

Erythromycin (stearate): 250 mg every 6 hours or 500 mg every 12 hours. In severe infections, dosage may be increased up to 4 g daily; however, a twice-daily dosing schedule is not recommended when dosage is >1 g daily.263

Pharyngitis and Tonsillitis
Oral

Erythromycin (base): 250 mg every 6 hours,262 d e 333 mg every 8 hours,242 262 d or 500 mg every 12 hours242 262 d e for 10 days.

Amebiasis
Entamoeba histolytica Infections
Oral

Erythromycin (base or stearate): 250 mg every 6 hours,242 d e 333 mg every 8 hours,242 263 or 500 mg every 12 hours242 263 d for 10–14 days.

Erythromycin (estolate): 250 mg 4 times daily for 10–14 days.i

Erythromycin (ethylsuccinate): 400 mg 4 times daily for 10–14 days.268 f

Anthrax†
IV

Erythromycin (lactobionate): 15–20 mg/kg (up to 4 g) daily given in divided doses every 6 hours.218

Must be used in multiple-drug regimens that initially include IV ciprofloxacin or IV doxycycline and 1 or 2 other anti-infectives predicted to be effective.216 347

Duration of treatment is 60 days if anthrax occurred as the result of exposure to anthrax spores in the context of biologic warfare or bioterrorism.216 347

Chancroid†
Oral

Erythromycin (base): 500 mg 3–4 times daily for 7 days.228 248

Erythromycin (ethylsuccinate): 800 mg 4 times daily for 7 days.248

Chlamydial Infections
Uncomplicated Urethral, Endocervical, or Rectal Infections
Oral

Erythromycin (base or stearate): 500 mg 4 times daily for 7 days.228 248 242 262 263 d e Alternatively, 666 mg every 8 hours for 7 days.242 262 263 If these regimens are not tolerated in pregnant women, a dosage of 500 mg every 12 hours, 333 mg every 8 hours, or 250 mg 4 times daily for at least 14 days.228 242 262 263

Erythromycin (estolate): 500 mg 4 times daily for 7 daysi

Erythromycin (ethylsuccinate): 800 mg 4 times daily for 7 days.228 248 If this regimen is not tolerated in pregnant women, a dosage of 400 mg 4 times daily for 14 days may be used.228

Presumptive Treatment of Chlamydial Infections in Adults with Gonorrhea
Oral

Erythromycin (base): 500 mg 4 times daily for 7 days.228

Erythromycin (ethylsuccinate): 800 mg 4 times daily for 7 days.228

Lymphogranuloma venereum†
Oral

Erythromycin (base): 500 mg 4 times daily for 21 days.228 248

Erythromycin (ethylsuccinate): 800 mg 4 times daily for 21 days.248

Diphtheria
Treatment of Diphtheria
Oral

Erythromycin: 40–50 mg/kg daily (maximum 2 g daily) for 14 days.261 311 Patients usually are no longer contagious 48 hours after initiation of anti-infective therapy.261 Eradication of the organism should be confirmed by 2 consecutive negative cultures following completion of therapy.261 311

Prevention of Diphtheria
Oral

Erythromycin: 1 g daily for 7–10 days.261 455

Elimination of Diphtheria Carrier State
Oral

Erythromycin: 1 g daily for 7–10 days.311 455 Obtain follow-up cultures ≥2 weeks after completion of therapy; if cultures are positive, an additional 10-day course should be given and additional follow-up cultures obtained.311 455

Granuloma Inguinale (Donovanosis)†
Oral

Erythromycin (base): 500 mg 4 times daily for ≥3 weeks or until all lesions have healed completely;228 consider adding IV aminoglycoside (e.g., gentamicin) if improvement is not evident within the first few days of therapy and in HIV-infected patients.228

Relapse can occur 6–18 months after apparently effective treatment.228

Legionnaires’ Disease
Oral

Erthromycin (base, ethylsuccinate, or stearate): 1–4 g daily in divided doses has been used alone or in conjunction with rifampin.242 311 262 263 268 311 452 453 d e f Usual duration is 10–21 days.311 452 453

IV

Erythromycin (lactobionate): 1–4 g daily in divided doses has been used alone or in conjunction with rifampin.311 452 453 c After a response is obtained, rifampin can be discontinued and therapy changed to oral erythromycin.311 452 453 Usual duration is 10–21 days.311 452 453

Early Localized or Early Disseminated Lyme Disease†
Oral

Erythromycin: 500 mg 4 times daily for 14–21 days.214 Alternatively, 250 mg 4 time daily for 14–21 days.274

Nongonococcal Urethritis
Oral

Erythromycin (base or stearate): 500 mg 4 times daily for 7 days.228 248 263 Alternatively, 666 mg every 8 hours for ≥7 days.242 262 263 For recurrent and persistent urethritis, CDC recommends 500 mg 4 times daily for 7 days in conjunction with a single dose of oral metronidazole (2 g).228

Erythromycin (ethylsuccinate): 800 mg 4 times daily for 7 days.228 248 268 f For recurrent and persistent urethritis, CDC recommends 800 mg 4 times daily for 7 days in conjunction with a single dose of oral metronidazole (2 g).228

Pelvic Inflammatory Disease (PID)
IV, then Oral

Erythromycin (lactobionate): 500 mg every 6 hours for 3 days.c Then switch to oral erythromycin (base or stearate) in a dosage of 250 mg every 6 hours for 7 days.c Alternatively, use follow-up oral dosage of 333 mg of erythromycin (base or stearate) every 8 hours for 7 days or 500 mg (base or stearate) every 12 hours for 7 days.242 262 263 d

Not included in CDC recommendations for treatment of PID.228

Pertussis
Treatment or Prevention of Pertussis
Oral

1 g daily in divided doses for 14 days.311 455

Syphilis
Oral

Erythromycin (base or stearate): 30–40 g given in divided doses over 10–15 days.242 262 263 d e

Erythromycin (estolate): 20 g given over 10 days.i

Erythromycin (ethylsuccinate): 48–64 g given over 10–15 days.268

CDC does not recommended erythromycin for treatment of syphilis.228

Preoperative Intestinal Antisepsis
Adjunct to Mechanical Cleansing in Patients Undergoing Colorectal Surgery
Oral

Erythromycin (base): if surgery is scheduled for 8 a.m., given 1 g of erythromycin and 1 g of oral neomycin sulfate at 1 p.m., 2 p.m., and 11 p.m. on the day preceding surgery.237 262

Prevention of Bacterial Endocarditis†
Patients Undergoing Certain Dental, Oral, Respiratory Tract, or Esophageal Procedures†
Oral

Erythromycin (ethylsuccinate): 800 mg 2 hours before the procedure and 400 mg 6 hours later.302

Erythromycin (stearate): 1 g 2 hours before the procedure and 500 mg 6 hours later.302

Prevention of Rheumatic Fever Recurrence
Oral

Erythromycin (base or stearate): 250 mg twice daily.242 263 311 392

Erythromycin (ethylsuccinate): 400 mg twice daily.268 f

Long-term continuous prophylaxis required.242 311 392

Prevention of Perinatal Group B Streptococcal Disease†
Women at Risk Who Should Not Receive β-lactam Anti-infectives†
IV

Erythromycin (lactobionate): 500 mg every 6 hours; initiate at time of labor or rupture of membranes and continue until delivery.415

Prescribing Limits

Pediatric Patients

Treatment of Infections
Oral

Maximum of 4 g daily.

Adults

Special Populations

Hepatic Impairment

It may be advisable to monitor serum erythromycin concentrations and modify dosage when indicated.a

Renal Impairment

Dosage adjustments not necessary in patients with impaired renal function.a

Cautions for Erythromycin (Systemic)

Contraindications

  • Hypersensitivity to erythromycins.263 268 f

  • Concomitant use with certain drugs highly dependent on CYP3A for metabolism and for which elevated plasma concentrations are associated with serious and/or life-threatening events (e.g., astemizole, cisapride, pimozide, terfenadine).263 268 f (See Specific Drugs under Interactions.)

  • Erythromycin estolate in patients with hepatic dysfunction or preexisting liver disease.a

  • Fixed combination of erythromycin ethylsuccinate and sulfisoxazole acetyl in patients hypersensitive to either component.264

Warnings/Precautions

Warnings

Superinfection/Clostridium difficile-associated Colitis

Possible emergence and overgrowth of nonsusceptible organisms.263 268 c f Institute appropriate therapy if superinfection occurs.263 268 c f

Treatment with anti-infectives may permit overgrowth of clostridia.263 268 467 468 469 470 471 b f Consider Clostridium difficile-associated diarrhea and colitis (antibiotic-associated pseudomembranous colitis) if diarrhea develops and manage accordingly.268 b f

Some mild cases of C. difficile-asssociated diarrhea and colitis may respond to discontinuance alone.263 268 467 468 469 470 471 b f Manage moderate to severe cases with fluid, electrolyte, and protein supplementation; appropriate anti-infective therapy (e.g., oral metronidazole or vancomycin) recommended if colitis is severe.263 268 467 468 469 470 471 b f

Hepatic Effects

Hepatic effects, including increased hepatic enzymes and hepatocellular and/or cholestatic hepatitis (with or without jaundice) have been reported with the various oral erythromycins and with parenteral erythromycin.217 222 223 224 263 268 c f

Erythromycin estolate has been associated with hepatotoxicity more frequently than other erythromycins.a Erythromycin estolate-induced hepatotoxicity is most likely to occur in patients who receive the drug for >10 days or in repeated courses.a

Erythroomycin estolate is contraindicated and other erythromycins should be used with caution in patients with impaired hepatic function.262 263 a In addition, monitoring of serum erythromycin concentrations and modification of dosage when indicated may be advisable in these patients.a

Interactions

Concomitant use with lovastatin requires caution since rhabdomyolysis (with or without renal impairment) has been reported.263 268 f (See Specific Drugs under Interactions.)

Sensitivity Reactions

Hypersensitivity Reactions

Anaphylaxis has been reported.c f Urticaria, mild skin eruptions, Stevens-Johnson syndrome, and toxic epidermal necrolysis also reported rarely.244 c f

General Precautions

Cardiac Effects

Cardiac arrhythmias (ventricular tachycardia) have been reported.c

Prolongation of the QT interval and development of ventricular arrhythmias, including atypical ventricular tachycardia (torsades de pointes), have been reported rarely with oral and IV erythromycin; limited data suggest that these adverse effects may depend on serum concentration and/or rate of infusion of the drug.260 305 306 307 308 360 362 376 481 Decreasing IV infusion rate may reduce the risk of cardiac toxicity, but may not eliminate the risk and discontinuance of the drug may be necessary.360 362

There is some evidence that use of oral erythromycin is associated with an increased risk of sudden death from cardiac causes (usually ventricular tachyarrhythmia) by a factor of 2.481 Concomitant use of oral erythromycin (a drug metabolized by CYP3A) with drugs that inhibit CYP3A (i.e., fluconazole, ketoconazole, itraconazole, diltiazem, verapamil) has been associated with an increased risk of sudden death from cardiac causes.481

Erythromycins should be used with caution in patients at risk for QT prolongation and/or accumulation of the anti-infective, particularly when the drug is administered IV.305 306 307 308 360 361 362 376

Myasthenia Gravis Patients

Possible aggravation of weakness reported in patients with myasthenia gravis.263 268 f

Use of Fixed Combination

When used in fixed combination with other agents, consider the cautions, precautions, and contraindications associated with the concomitant agents.

Specific Populations

Pregnancy

Category B.263 268 b c f

The fixed-combination preparation containing erythromycin ethylsuccinate and sulfisoxazole should not be used in pregnant women at term.264

Lactation

Distributed into milk.263 268 b c f Use with caution.263 268 b c f

The fixed-combination preparation containing erythromycin ethylsuccinate and sulfisoxazole should not be used in mothers who are nursing infants <2 months of age.264

Pediatric Use

The fixed-combination preparation containing erythromycin ethylsuccinate and sulfisoxazole should not be used in infants <2 months of age.264

Hepatic Impairment

Principally eliminated by the liver.268 c f Use caution in patients with impaired hepatic function.262 268 c f

Common Adverse Effects

GI effects (abdominal pain and cramping, nausea, vomiting, diarrhea, anorexia).263 268 a f Venous irritation and thrombophlebitis with IV administration.c

Interactions for Erythromycin (Systemic)

Metabolized by CYP3A isoenzymes.b Inhibits CYP3A isoenzymes.352 b

Drugs Affecting or Metabolized by Hepatic Microsomal Enzymes

Pharmacokinetic interactions likely with drugs that are inhibitors, inducers, or substrates of CYP isoenzymes with possible alteration in metabolism of erythromycin and/or the other drug.349 350 351 352 357 358 481 a b

Specific Drugs

Drug

Interaction

Comments

Antiarrhythmic agents (digoxin, disopyramide, quinidine)

Increased concentrations of the antiarrhythmic agent and increased risk of serious adverse cardiovascular effects298 299 309 393

Use with caution and monitor closely393

Anticoagulants, oral (warfarin)

Possible prolonged PT210 211 220 221

Monitor PT or other appropriate tests closely if used with warfarin; reduce anticoagulant dosage if necessary211 220 221

Antifungals, azoles (fluconazole, itraconazole, ketoconazole)

Possible increased erythromycin concentrations and increased risk of sudden death from cardiac causes481

Avoid concomitant use481

Antihistamines (astemizole, terfenadine)

Pharmacokinetic interaction and potential for serious or life-threatening reactions (e.g., cardiac arrhythmias) with astemizole or terfenadine (drugs no longer commercially available in the US)298 315 318 324 325 329

Concomitant use contraindicated315 320 324 439

Benzodiazepines (alprazolam, midazolam, triazolam)

Increased plasma concentrations of benzodiazepines; possible prolonged sedative and hypnotic effects of the drugs332 333

Monitor carefully and adjust dosage of benzodiazepine as needed239 333

Calcium-channel blocking agents

Diltiazem and Verapamil: Possible increased erythromycin concentrations and possible increased risk of sudden death from cardiac causes481

Nefedipine: No evidence of increased risk of sudden death from cardiac causes481

Diltiazem and Verapamil: Avoid concomitant use481

Carbamazepine

Increased carbamazepine concentrations and risk of carbamazepine toxicity210 220 221

Monitored for evidence of carbamazepine toxicity; carbamazepine dosage should be reduced when necessary.210 220 221

Consider use of an alternative anti-infective agent.221

Chloramphenicol

In vitro evidence of antagonisma

Cisapride

Possible increased cisapride concentrations and increased risk of adverse effects (e.g., cardiac effects)422 479 480

Concomitant use contraindicated263 268 f

Clindamycin or lincomycin

In vitro evidence of antagonisma

Ergot alkaloids (dihydroergotamine, ergonovine, ergotamine, methylergonovine)

Possibility of pharmacokinetic interaction; potential for serious or life-threatening reactions (e.g., acute ergot toxicity)b

HMG-CoA reductase inhibitors (lovastatin, simvastatin)

Increased concentrations of some HMG-CoA reductase inhibitors with potential for increased risk of myopathy (including rhabdomyolysis)359 391 b

If used concomitantly with lovastatin, closely monitor CK and serum transaminase concentrationsb

Immunosuppressive agents (cyclosporine)

Increased cyclosporine concentrations and increased risk of cyclosporine toxicity231 232 233 234 235 236

Use concomitantly with caution and monitor for evidence of cyclosporine toxicity.231 232 233 234 236

Monitor cyclosporine concentrations if possible; adjust dosage as needed when erythromycin is initiated or discontinued.231 232 233 234 236

Pimozide

Possible increased pimozide concentrations and increased risk of life-threatening cardiac dysrhythmias 263 268 f

Concomitant use contraindicated263 268 f

Sildenafil

Increased sildenafil concentrationsb

Consider reducing sildenafil dosageb

Theophylline

Increased theophylline concentrations;210 220 221 possible decreased erythromycin concentrations210 220 221

Use with caution; monitor serum theophylline concentrations and adjust theophylline dosage if indicated210 220 221

Erythromycin (Systemic) Pharmacokinetics

Absorption

Bioavailability

Erythromycin base, estolate, ethylsuccinate, and stearate are readily absorbed from GI tract;263 268 f peak serum concentrations attained within 1–4 hours.a

Erythromycin base is highly susceptible to gastric acid inactivation, and commercially available tablets are coated with acid-resistant (enteric) coatings or are buffered to protect the drug from gastric acidity.a The stearate also is highly susceptible to gastric acid inactivation, but the estolate and ethylsuccinate are acid stable.a

Food

Most commercial erythromycin preparations are well absorbed in fasting or nonfasting state.263 268 f

Distribution

Extent

Widely distributed into most body tissues and fluids.263 268 c f

Only low concentrations (2–13% of serum concentrations) are distributed into CSF.263 268 c f

Crosses the placenta and is distributed into milk.263 268 c f

Plasma Protein Binding

Erythromycin base is 73–81% bound and erythromycin estolate is approximately 96% bound to serum proteins.219

Elimination

Metabolism

Erythromycin is partially metabolized in the liver by CYP3A4 by N-demethylation to inactive, unidentified metabolites.482 a

Erythromycin ethylsuccinate is partially dissociated in the intestine where both erythromycin and the undissociated ester are absorbed; in the blood, the ester is partially hydrolyzed to release free erythromycin.a

Erythromycin estolate dissociates in the upper intestine, liberating the inactive propanoate ester which is absorbed and partially hydrolyzed in the blood to release free erythromycin.a

Elimination Route

Concentrated in the liver and eliminated in bile.263 268 c f Less than 5% of an oral dose eliminated unchanged in urine;263 268 12–15% of an IV dose is eliminated unchanged in urine.c

Not removed by hemodialysis or peritoneal dialysis.c

Half-life

Serum half-life of erythromycin in patients with normal renal function usually is 1.5–2 hours, but may range from 0.8–3 hours.a

Special Populations

Half-life may be prolonged in patients with hepatic impairment.a The terminal elimination half-life in adults with alcoholic liver disease is similar to that in healthy adults, but the initial distribution half-life is slightly prolonged and average and peak serum concentrations were higher.a

In anuric patients, serum half-life may be prolonged to 6 hours, but this is not considered clinically important.a

Stability

Storage

Oral

Capsules

Erythromycin base (delayed-release): <30°C.e f

Tablets

Erythromycin base (delayed-release and film-coated): <30°C.262 b d

Erythromycin ethylsuccinate (chewable and film-coated): <30°C.268 f

Erythromycin stearate (film-coated): <30°C.263

For Suspension

Erythromycin ethylsuccinate: <30°C.268 f After reconstitution of E.E.S. granules, refrigerate and use within 10 days.268 After reconstitution of EryPed, store at <25°C and use within 35 days.f

Fixed combination of erythromycin ethylsuccinate and sulfisoxazole acetyl: <30°C. After reconstitution, refrigerate and discard after 14 days.264

Suspension

Erythromycin ethylsuccinate: 2–8°C until dispensed; once dispensed, stable for 14 days at room temperature.268

Parenteral

Powder for IV Infusion

Erythromycin lactobionate: preferably 15–30°C.c Following reconstitution, administer within 8 hours if diluted in 0.9% sodium chloride or within 2 hours if diluted in 5% dextrose injection.c

Compatibility

For information on systemic interactions resulting from concomitant use, see Interactions.

Parenteral

Solution Compatibility (Erythromycin Lactobionate)HID

Compatible

Sodium chloride 0.9%

Incompatible

Dextrose 2½% in half-strength Ringer’s injection, lactated

Dextrose 5% in Ringer’s injection, lactated

Dextrose 10% in water

Multielectrolyte solution

Normosol M in dextrose 5%

Normosol R

Ringer’s injection

Variable

Dextrose 5% in sodium chloride 0.9%

Dextrose 5% in water

Ringer’s injection, lactated
Drug Compatibility
Admixture Compatibility (Erythromycin Lactobionate)HID

Compatible

Aminophylline

Ampicillin sodium

Cimetidine HCl

Diphenhydramine HCl

Hydrocortisone sodium succinate

Lidocaine HCl

Penicillin G potassium

Penicillin G sodium

Pentobarbital sodium

Polymyxin B sulfate

Potassium chloride

Prochlorperazine edisylate

Ranitidine HCl

Sodium bicarbonate

Verapamil HCl

Incompatible

Colistimethate sodium

Furosemide

Heparin sodium

Linezolid

Metaraminol bitartrate

Metoclopramide HCl

Vitamin B complex with C

Variable

Ascorbic acid injection
Y-Site Compatibility (Erythromycin Lactobionate)HID

Compatible

Acyclovir sodium

Amiodarone HCl

Bivalirudin

Cyclophosphamide

Dexmedetomidine HCl

Diltiazem HCl

Doxapram HCl

Enalaprilat

Esmolol HCl

Famotidine

Fenoldopam mesylate

Foscarnet sodium

Heparin sodium

Hetastarch in lactated electrolyte injection (Hextend)

Hydromorphone HCl

Idarubicin HCl

Labetalol HCl

Lorazepam

Magnesium sulfate

Meperidine HCl

Midazolam HCl

Morphine sulfate

Multivitamins

Nicardipine HCl

Perphenazine

Tacrolimus

Theophylline

Vitamin B complex with C (Berocca-C or Berocca-C 500)

Zidovudine

Incompatible

Ceftazidime

Fluconazole

Actions and Spectrum

  • Usually bacteriostatic; may be bactericidal in high concentrations or against highly susceptible organisms.a

  • Inhibits protein synthesis in susceptible organisms by binding to 50S ribosomal subunits.268 a c f

  • Spectrum of activity includes many gram-positive and -negative bacteria and some other organisms (e.g., Chlamydia, Mycoplasma, spirochetes).a Inactive against fungi and viruses.a

  • Gram-positive bacteria: active in vitro and in clinical infections against S. aureus (resistant strains may emerge during therapy), S. pyogenes (group A β-hemolytic streptococci), viridans streptococci, S. pneumoniae, Bacillus anthracis, Corynebacterium diphtheriae, C. minutissimum, and Listeria monocytogenes.268 a c f

  • Gram-negative bacteria: active in vitro and in clinical infections against Bordetella pertussis, Legionella pneumophila, Moraxella catarrhalis, and Neisseria gonorrhoeae.268 c f Enterobacteriaceae (e.g., Escherichia coli, Enterobacter, Klebsiella, Proteus, Salmonella, Shigella) and Pseudomonas usually are resistant.a Haemophilus influenzae usually are resistant to erythromycin alone, but are susceptible to erythromycin used in conjunction with sulfisoxazole.268 f

  • Other organisms: active against Chlamydia psittaci, C. trachomatis, Mycoplasma pneumoniae, Ureoplasma urealyticum, Entamoeba histolytica, Borrelia burgdorferi, and Treponema pallidum.240 268 289 290 292 293 296 a c f

  • Cross-resistance generally occurs among the macrolides, including erythromycin, azithromycin, and clarithromycin.a

Advice to Patients

  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs.

  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.

  • Importance of advising patients of other important precautionary information. (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Erythromycin

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Capsules, delayed-release (containing enteric-coated pellets)

250 mg*

ERYC (with povidone)

Warner Chilcott

Erythromycin Delayed-Release Capsules

Abbott, Barr, Major, Parmed, Purepac

Tablets, delayed-release (containing enteric-coated particles)

333 mg

PCE Dispertab (with povidone and propylene glycol)

Abbott

500 mg

PCE Dispertab (with povidone and propylene glycol)

Abbott

Tablets, delayed-release (enteric-coated)

250 mg

Ery-Tab

Abbott

333 mg

Ery-Tab (with povidone)

Abbott

500 mg

Ery-Tab (with povidone)

Abbott

Tablets, film-coated

250 mg

Erythromycin Base Filmtab (with propylene glycol)

Abbott

500 mg

Erythromycin Base Filmtab (with propylene glycol)

Abbott

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Erythromycin Estolate

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Capsules

250 mg (of erythromycin)*

Erythromycin Estolate Capsules

Barr

Suspension

125 mg (of erythromycin) per 5 mL*

Erythromycin Estolate Suspension

Alpharma

250 mg (of erythromycin) per 5 mL*

Erythromycin Estolate Suspension

Alpharma

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Erythromycin Ethylsuccinate

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

For suspension

100 mg (of erythromycin) per 2.5 mL

EryPed Drops

Abbott

200 mg (of erythromycin) per 5 mL

E.E.S. Granules

Abbott

EryPed

Abbott

400 mg (of erythromycin) per 5 mL

EryPed

Abbott

Suspension

200 mg (of erythromycin) per 5 mL*

E.E.S. Liquid (with parabens)

Abbott

400 mg (of erythromycin) per 5 mL*

E.E.S. Liquid (with parabens)

Abbott

Tablets, chewable

200 mg (of erythromycin)

EryPed (scored)

Abbott

Tablets, film-coated

400 mg (of erythromycin)*

E.E.S. Filmtab (with propylene glycol)

Abbott

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Erythromycin Ethylsuccinate Combinations

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

For suspension

200 mg (of erythromycin) per 5 mL with Sulfisoxazole Acetyl 600 mg (of sulfisoxazole) per 5 mL*

Eryzole

Alra

Pediazole

Ross
Erythromycin Lactobionate

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Parenteral

For injection, for IV infusion only

500 mg (of erythromycin)

Erythrocin Lactobionate-I.V. ADD-Vantage

Abbott

1 g (of erythromycin)

Erythrocin Lactobionate-I.V. (with benzyl alcohol 180 mg)

Abbott

Erythrocin Lactobionate-I.V. ADD-Vantage

Abbott

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Erythromycin Stearate

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Tablets, film-coated

250 mg (of erythromycin)*

Erythrocin Stearate Filmtab (with povidone propylene glycol and sorbic acid)

Abbott

Erythromycin Stearate Tablets

Mylan

500 mg (of erythromycin)*

Erythrocin Stearate Filmtab (with povidone and propylene glycol)

Abbott

Erythromycin Stearate Tablets

Mylan

AHFS DI Essentials™. © Copyright 2021, Selected Revisions July 1, 2005. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

References

Only references cited for selected revisions after 1984 are available electronically.

210. Ludden TM. Pharmacokinetic interactions of the macrolide antibiotics. Clin Pharmacokinet. 1985; 10:63-79. http://www.ncbi.nlm.nih.gov/pubmed/3882305?dopt=AbstractPlus

211. Sato RI, Gray DR, Brown SE. Warfarin interaction with erythromycin. Arch Intern Med. 1984; 144:2413-4. http://www.ncbi.nlm.nih.gov/pubmed/6508448?dopt=AbstractPlus

212. Errick JK, Hyrciuk-Flaska L, Thies H. Probable erythromycin ototoxicity. Drug Intell Clin Pharm. 1980; 14:623-5.

213. Kroboth PD, McNeil MA, Kreeger A et al. Hearing loss and erythromycin pharmacokinetics in a patient receiving hemodialysis. Arch Intern Med. 1983; 143:1263-5. http://www.ncbi.nlm.nih.gov/pubmed/6860057?dopt=AbstractPlus

214. Wormser GP, Nadelman RB, Dattwyler RJ et al. Practice guidelines for the treatment of Lyme disease. Clin Infect Dis 2000; 31(Suppl 1)S1-14.

215. Centers for Disease Control and Prevention. Use of anthrax vaccines in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2000; 49(No. RR-15):1-20. http://www.ncbi.nlm.nih.gov/pubmed/10993565?dopt=AbstractPlus http://www.cdc.gov/mmwr/PDF/rr/rr4915.pdf

216. Inglesby TV, O’Toole T, Henderson DA et al. Anthrax as a biological weapon, 2002. Updated recommendations for management. JAMA. 2002; 287:2236-52. http://www.ncbi.nlm.nih.gov/pubmed/11980524?dopt=AbstractPlus

217. Diehl AM, Latham P, Boitnott JK et al. Cholestatic hepatitis from erythromycin ethylsuccinate. Am J Med. 1984; 76:931-4. http://www.ncbi.nlm.nih.gov/pubmed/6609640?dopt=AbstractPlus

218. Dixon TC, Meselson M, Guillemin J et al. Anthrax. N Engl J Med. 1999; 341:815-26. http://www.ncbi.nlm.nih.gov/pubmed/10477781?dopt=AbstractPlus

219. Vallner JJ. Binding of drugs by albumin and plasma protein. J Pharm Sci. 1977; 66:447-65. http://www.ncbi.nlm.nih.gov/pubmed/323460?dopt=AbstractPlus

220. Hansten PD. Drug interactions. 5th ed. Philadelphia: Lea & Febiger; 1985:80-1,117,211.

221. Shinn AF, Shrewsbury RP. Evaluations of drug interactions. 3rd ed. St. Louis, MO: CV Mosby Company; 1985:168,213,221,388,633,647.

222. Inman WH, Rawson NS. Erythromycin estolate and jaundice. BMJ. 1983; 286:1954-6. http://www.ncbi.nlm.nih.gov/pubmed/6407653?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1548281&blobtype=pdf

223. Sullivan D, Csuka ME, Blanchard B. Erythromycin ethylsuccinate hepatotoxicity. JAMA. 1980; 243:1074. http://www.ncbi.nlm.nih.gov/pubmed/6965509?dopt=AbstractPlus

224. Food and Drug Administration. Erythromycin estolate: withdrawal of proposal to revoke provisions for certification of tablets and capsules; response to petition; labeling. (Docket No. 79N-0459). Fed Regist. 1982; 47:22547-68.

225. Odendall MW, Pieterson PM, de Vos V et al. The antibiotic sensitivity patterns of bacilluls anthracis isolated from the Kruger national park. J Vet Res. 1991; 58:17-9.

226. Centers for Disease Control and Prevention. Antimicrobial susceptibility of Bacillus anthracis isolates associated with intentional distribution in Florida, New Jersey, New York, Pennsylvania, Virginia, and Washington D.C., September-October, 2001. CDC Health Advisory from the CDC website (http://www.emergency.cdc.gov).

227. Turnball PCB. Guidelines for surveillance and control of anthrax in human and animals. 3rd ed. Geneva, Switzerland: World Health Organization, Department of Communicable Diseases Surveillance and Response. Publication N. WHO/EMC/ZSI./98.6. 1998. From WHO website (http://www.who.int).

228. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2002. MMWR Morb Mortal Wkly Rep. 2002; 51(No. RR-6):1-78. http://www.cdc.gov/mmwr/PDF/rr/rr5106.pdf

229. Anon. Hypertrophic pyloric stenosis in infants following pertussis prophylaxis with erythromycin— Knoxville, Tennessee, 1999. MMWR Morb Mortal Wkly Rep. 1999; 48:1117-20. http://www.ncbi.nlm.nih.gov/pubmed/10634345?dopt=AbstractPlus

230. Honein MA, Paulozzi LJ, Himelright IM et al. Infantile hypertrophic pyloric stenosis after pertussis prophylaxis with erythromycin: a case review and cohort study. Lancet. 1999; 354:2101-5. http://www.ncbi.nlm.nih.gov/pubmed/10609814?dopt=AbstractPlus

231. Ptachcinski RJ, Carpenter BJ, Burckart GJ et al. Effect of erythromycin on cyclosporine levels. N Engl J Med. 1985; 313:1416-7. http://www.ncbi.nlm.nih.gov/pubmed/4058537?dopt=AbstractPlus

232. Kohan DE. Possible interaction between cyclosporine and erythromycin. N Engl J Med. 1986; 314:448. http://www.ncbi.nlm.nih.gov/pubmed/3511381?dopt=AbstractPlus

233. Martel R, Heinrichs D, Stiller CR et al. The effects of erythromycin in patients treated with cyclosporine. Ann Intern Med. 1986; 104:660-1. http://www.ncbi.nlm.nih.gov/pubmed/3963664?dopt=AbstractPlus

234. Godin JRP, Sketris IS, Belitsky P. Erythromycin–cyclosporine interaction. Drug Intell Clin Pharm. 1986; 20:504-5. http://www.ncbi.nlm.nih.gov/pubmed/3522164?dopt=AbstractPlus

235. Freeman DJ, Martell R, Carruthers SG et al. The effect of erythromycin on the pharmacokinetics of cyclosporine. Clin Pharmacol Ther. 1986; 39:193.

236. Hansten PD, Horn JR. Erythromycin interactions. Drug Interact Newsl. 1986; 6(Updates):U11-2.

237. Anon. Antimicrobial prophylaxis in surgery. Med Lett Drugs Ther. 2001; 43:92-7. http://www.ncbi.nlm.nih.gov/pubmed/11689761?dopt=AbstractPlus

238. Phillips JP, Antal EJ, Smith RB. A pharmacokinetic drug interaction between erythromycin and triazolam. J Clin Psychopharmacol. 1986; 6:297-9. http://www.ncbi.nlm.nih.gov/pubmed/3771812?dopt=AbstractPlus

239. Pharmacia & UpJohn. Halcion (triazolam) prescribing information (dated 1999 May). In: Physicians’ desk reference. 56th ed. Montvale, NJ: Medical Economics Company Inc; 2002:2823-5.

240. Johnson SE, Klein GC, Schmid GP et al. Susceptibility of the Lyme disease spirochete to seven antimicrobial agents. Yale J Biol Med. 1984; 57:549-53. http://www.ncbi.nlm.nih.gov/pubmed/6516457?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=2590022&blobtype=pdf

242. Abbott Laboratories. PCE (erythromycin particles in tablets) prescribing information (dated 2000 Feb). Physicians’ desk reference. 56th ed. Montvale, NJ: Medical Economics Company Inc; 2002:498-500.

243. Cooper RJ, Hoffman JR, Bartlett JG et al. Principles of appropriate antibiotic use for acute pharyngitis in adults: background. Ann Intern Med. 2001; 134:509-17. http://www.ncbi.nlm.nih.gov/pubmed/11255530?dopt=AbstractPlus

244. Lestico MR, Smith AD. Stevens-Johnson syndrome following erythromycin administration. Am J Health-Syst Pharm. 1995; 52:1805-7. http://www.ncbi.nlm.nih.gov/pubmed/8528839?dopt=AbstractPlus

246. American Academy of Pediatrics Committee on Infectious Diseases and Committee on Fetus and newborn. Revised guidelines for prevention of early-onset group B streptococcal (GBS) infection. Pediatrics. 1997; 99:489-96. http://www.ncbi.nlm.nih.gov/pubmed/9041310?dopt=AbstractPlus

247. Hashisaki P, Wertzberger GG, Conrad GL et al. Erythromycin failure in the treatment of syphilis in a pregnant woman. Sex Transm Dis. 1983; 10:36-8. http://www.ncbi.nlm.nih.gov/pubmed/6601848?dopt=AbstractPlus

248. Anon. Drugs for sexually transmitted infections. Med Lett Treat Guid. 2004; 2:67-74.

249. Centers for Disease Control. Congenital syphilis—United States, 1983–1985. MMWR Morb Mortal Wkly Rep. 1986; 35:625-8. http://www.ncbi.nlm.nih.gov/pubmed/3093832?dopt=AbstractPlus

250. Bass JW. Erythromycin for pertussis: probable reasons for past failures. Lancet. 1985; 2:147. http://www.ncbi.nlm.nih.gov/pubmed/2862331?dopt=AbstractPlus

251. Bass JW. Erythromycin for treatment and prevention of pertussis. Pediatr Infect Dis. 1986; 5:154-7. http://www.ncbi.nlm.nih.gov/pubmed/2868449?dopt=AbstractPlus

252. Bergquist SO, Bernander S, Doahnsjo H et al. Erythromycin in the treatment of pertussis: a study of bacteriologic and clinical effects. Pediatr Infect Dis J. 1987; 6:458-61. http://www.ncbi.nlm.nih.gov/pubmed/2885802?dopt=AbstractPlus

253. Steketee RW, Wassilak SGF, Adkins WN et al. Evidence for a high attack rate and efficacy of erythromycin prophylaxis in a pertussis outbreak in a facility for the developmentally disabled. J Infect Dis. 1988; 157:434-40. http://www.ncbi.nlm.nih.gov/pubmed/3257783?dopt=AbstractPlus

254. Halsey NA, Welling MA, Lehman RM. Nosocomial pertussis: a failure of erythromycin treatment and prophylaxis. Am J Dis Child. 1980; 134:521-2. http://www.ncbi.nlm.nih.gov/pubmed/7377164?dopt=AbstractPlus

255. Bass JW. Use of erythromycin in pertussis outbreaks. Pediatrics. 1983; 72:748-9. http://www.ncbi.nlm.nih.gov/pubmed/6356008?dopt=AbstractPlus

256. Schultze JM, Schmid GP. Recommendations for treatment of chancroid, 1993. Clin Infect Dis. 1995; 20(Suppl a):S39-46.

257. Nichols RL, Smith JW, Garcia RY et al. Current practices of preoperative bowel preparation among North American colorectal surgeons. Clin Infect Dis. 1997; 24:609-19. http://www.ncbi.nlm.nih.gov/pubmed/9145734?dopt=AbstractPlus

258. Schoetz DJ, Roberts PL, Murray JJ et al. Addition of parenteral cefoxitin to regimen of oral antibiotics for elective colorectal operations. A randomized prospective study. Ann Surg. 1990; 212:209-12. http://www.ncbi.nlm.nih.gov/pubmed/2100983?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1358059&blobtype=pdf

259. Anon. Drugs for parasitic infections. Med Lett Drugs Ther. Aug 2004. From the Medical Letter website (http://www.medletter.com).

260. Orban Z, MacDonald LL, Peters MA et al. Erythromycin-induced cardiac toxicity. Am J Cardiol. 1995; 75:859-61. http://www.ncbi.nlm.nih.gov/pubmed/7536388?dopt=AbstractPlus

261. Centers for Disease Control and Prevention. Epidemiology and prevention of vaccine-preventable diseases. 7th ed. Public Health Foundation; 2002 Jan:39-48,58-70.

262. Abbott Laboratories. ERY-TAB (erythromycin delayed-release tablets, enteric-coated) prescribing information (dated 2001 Feb). In: Physicians’ desk reference. 56th ed. Montvale, NJ: Medical Economics Company Inc; 2002:448-50.

263. Abbott Laboratories. Erythrocin stearate (erythromycin stearate) tablets prescribing information (dated 2000 Nov). In Physicians’ desk reference. 56th ed. Montvale, NJ: Medical Economics Company Inc; 2002:452-4.

264. Ross. Pediazole (erythromycin ethylsuccinate and sulfisoxazole acetyl for oral suspension) prescribing information (dated 1994 Jul). In Physicians’ desk reference 56th ed. Montvale, NJ: Medical Economics Company Inc; 2002:3050-1.

265. Thompson C, Spielman A, Krause P. Coinfecting deer-associated zoonoses: Lyme disease, babesiosis, and ehrlichiosis. Clin Infect Dis. 2000; 33:676-85.

266. Dattwyler RJ, Grunwaldt E, Luft BJ. Clarithromycin in treatment of early Lyme disease: a pilot study. Antimicrob Agents Chemother. 1996; 40:468-9. http://www.ncbi.nlm.nih.gov/pubmed/8834900?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=163136&blobtype=pdf

267. Thompson C, Spielman A, Krause P. Coinfecting deer-associated zoonoses: Lyme disease, babesiosis, and ehrlichiosis. Clin Infect Dis. 2000; 33:676-85.

268. Abbott Laboratories. E.E.S. (erythromycin ethylsuccinate) prescribing information (dated 2000 Feb). In: Physicians’ desk reference. 56th ed. Montvale, NJ: Medical Economics Company Inc; 2002:450-2.

269. American Thoracic Society. Guidelines for the management of adults with community-acquired pneumonia. Diagnosis, assessment of severity, antimicrobial therapy, and prevention. Am J Resp Crit Care Med. 2001; 163:1730-54. http://www.ncbi.nlm.nih.gov/pubmed/11401897?dopt=AbstractPlus

270. Bartlett JG, Dowell SF, Mandell LA et al. Practice guidelines for the management of community-acquired pneumonia in adults. Clin Infect Dis. 2000; 31:347-82. http://www.ncbi.nlm.nih.gov/pubmed/10987697?dopt=AbstractPlus

271. Guerrant RL, Gilder TV, Steiner TS et al. Practice guidelines for the management of infectious diarrhea. Clin Infect Dis. 2001; 32:331-50. http://www.ncbi.nlm.nih.gov/pubmed/11170940?dopt=AbstractPlus

272. Centers for Disease Control and Prevention. Diagnosis and management of foodborne illness. A primer for physicians. MMWR Morb Mortal Wkly Rep. 2001; 50(RR-2):1-69. http://www.ncbi.nlm.nih.gov/pubmed/11215787?dopt=AbstractPlus http://www.cdc.gov/mmwr/PDF/rr/rr5002.pdf

273. Funderburg LG, Vertrees JE, True JE et al. Seizure following addition of erythromycin to clozapine treatment. Am J Psychiatr. 1994; 151:1840-1. http://www.ncbi.nlm.nih.gov/pubmed/7977898?dopt=AbstractPlus

274. Steere AC. Lyme disease. N Engl J Med. 2001; 345:115-25. http://www.ncbi.nlm.nih.gov/pubmed/11450660?dopt=AbstractPlus

275. Centers for Disease Control and Prevention. 1998 Guidelines for treatment of sexually transmitted diseases. MMWR Morb Mortal Wkly Rep. 1997; 47(RR-1):1-116. http://www.cdc.gov/mmwr/PDF/rr/rr4701.pdf

276. Heffelfinger JD, Dowell SF, Jorgensen JH et al. Management of community-acquired pneumonia in the era of pneumococcal resistance. A report from the drug-resistant Streptococcus pneumoniae therapeutic working group. Arch Intern Med. 2000; 160:1399-1408. http://www.ncbi.nlm.nih.gov/pubmed/10826451?dopt=AbstractPlus

279. Johnson RC. Isolation techniques for spirochetes and their sensitivity to antibiotics in vitro and in vivo. Rev Infect Dis. 1989; 11(Suppl 6):S1505-10. http://www.ncbi.nlm.nih.gov/pubmed/2682963?dopt=AbstractPlus

289. Luft BJ, Volkman DJ, Halperin JJ et al. New chemotherapeutic approaches in the treatment of Lyme borreliosis. Ann NY Acad Sci. 1988; 539:352-61. http://www.ncbi.nlm.nih.gov/pubmed/3056203?dopt=AbstractPlus

290. Mursic VP, Wilske B, Schierz G. In vitro and in vivo susceptibility of Borrelia burgdorferi. Eur J Clin Microbiol. 1987; 6:424-6. http://www.ncbi.nlm.nih.gov/pubmed/3665899?dopt=AbstractPlus

292. Preac-Mursic V, Wilske B, Schierz G. European Borrelia burgdorferi isolated from humans and ticks: culture conditions and antibiotic susceptibility. Zentralbl Bakteriol Mikrobiol Hyg [A]. 1986; 263:112-8. http://www.ncbi.nlm.nih.gov/pubmed/3577473?dopt=AbstractPlus

293. Johnson RC, Kodner C, Russell M. In vitro and in vivo susceptibility of the Lyme disease spirochete, Borrelia burgdorferi, to four antimicrobial agents. Antimicrob Agents Chemother. 1987; 31:164-7. http://www.ncbi.nlm.nih.gov/pubmed/3566246?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=174684&blobtype=pdf

296. Berger BW, Kaplan MH, Rothenberg IR et al. Isolation and characterization of the Lyme disease spirochete from the skin of patients with erythema chronicum migrans. J Am Acad Dermatol. 1985; 13:444-9. http://www.ncbi.nlm.nih.gov/pubmed/3902917?dopt=AbstractPlus

297. Ergot alkaloid/erythromycin. In: Tatro DS, Olin BR. Drug Interaction Facts. St. Louis: JB Lippincott Co; 1989(Apr):315.

298. Parke-Davis. Eryc (erthromycin delayed-release capsules) prescribing information (dated 1994 June). In: Physicians’ desk reference. 50th ed. Montvale, NJ: Medical Economics Company Inc; 1996:1915-7.

299. Oral digoxin/erythromycin. Tatro DS, Olin BR. Drug Interaction Facts. St. Louis: JB Lippincott Co; 1989(Oct):281.

301. Berger BW, Johnson RC. Clinical and microbiologic findings in six patients with erythema migrans of Lyme disease. J Am Acad Dermatol. 1989; 21:1188-91. http://www.ncbi.nlm.nih.gov/pubmed/2511231?dopt=AbstractPlus

302. Dajani AS, Bisno AL, Chung KJ et al. Prevention of bacterial endocarditis: recommendations by the American Heart Association. JAMA. 1990; 264:2919-22. http://www.ncbi.nlm.nih.gov/pubmed/2146414?dopt=AbstractPlus

305. Schoenenberger RA, Haefeli WE, Weiss P et al. Association of intravenous erythromycin and potentially fatal ventricular tachycardia with Q-T prolongation (torsades de pointes). Br Med J. 1990; 300:1375-6.

306. McComb JM, Campbell NPS, Cleland J. Recurrent ventricular tachycardia associated with QT prolongation after mitral valve replacement and its association with intravenous administration of erythromycin. Am J Cardiol. 1984; 54:922-3. http://www.ncbi.nlm.nih.gov/pubmed/6486045?dopt=AbstractPlus

307. Guelon D, Bedock B, Chartier C et al. QT prolongation and recurrent “torsades de pointes” during erythromycin lactobionate infusion. Am J Cardiol. 1986; 58:666. http://www.ncbi.nlm.nih.gov/pubmed/3751946?dopt=AbstractPlus

308. Ponsonnaille J, Citron B, Richard A et al. [Electrophysiological study of pro-arrhythmogenic effects of erythromycin]. Arch Mal Coeur. 1988; 81:1001-8. http://www.ncbi.nlm.nih.gov/pubmed/3144248?dopt=AbstractPlus

309. Ragosta M, Weihl AC, Rosenfeld LE. Potentially fatal interaction between erythromycin and disopyramide. Am J Med. 1989; 86:465-6. http://www.ncbi.nlm.nih.gov/pubmed/2467560?dopt=AbstractPlus

310. Reviewers’ comments (personal observations).

311. Committee on Infectious Diseases, American Academy of Pediatrics. 2000 Red book: report of the Committee on Infectious Diseases. 25th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2000:164-6,196-8,203-12,230-4,254-72,364-5,374-9,435-48,526-44.

313. Barr. Erythromycin estolate capsules and oral suspension prescribing information. Pomona, NY; 1990 Oct.

314. Rahn DW, Malawista SE. Lyme disease: recommendations for diagnosis and treatment. Ann Intern Med. 1991; 114:472-81. http://www.ncbi.nlm.nih.gov/pubmed/1994795?dopt=AbstractPlus

315. Marion Merrell Dow. Seldane (terfenadine) tablets prescribing information. Kansas City, MO; 1993 Jan.

316. Marion Merrell Dow, Kansas City, MO: Personal communication.

317. Marion Merrell Dow. Dear health care professional letter regarding appropriate use of Seldane. Kansas City, MO: July 7, 1992.

318. Honig PK, Zamani K, Woosley RL et al. Erythromycin changes terfenadine pharmacokinetics & electrocardiographic pharmacodynamics. Clin Pharmacol Ther. 1992; 51:156.

319. Mathews DR, McNutt B, Okerholm R et al. Torsades de pointes occurring in association with terfenadine use. JAMA. 1991; 266:2375-6. http://www.ncbi.nlm.nih.gov/pubmed/1920744?dopt=AbstractPlus

320. Cruzan S (US Food and Drug Administration). HHS News. Press release No. P92-22. 1992 Jul 7.

321. Cortese L, Bjornson DC. Potential interaction between terfenadine and macrolide antibiotics. Clin Pharm. 1992; 11:675. http://www.ncbi.nlm.nih.gov/pubmed/1511540?dopt=AbstractPlus

322. Cortese LM, Bjornson DC. Comment: the new macrolide antibiotics and terfenadine. Ann Pharmacother. 1992; 26:1019. http://www.ncbi.nlm.nih.gov/pubmed/1504390?dopt=AbstractPlus

323. Dylewski J. Irreversible sensorineural hearing loss due to erythromycin. CMAJ. 1988; 139:230-1. http://www.ncbi.nlm.nih.gov/pubmed/3395937?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1268068&blobtype=pdf

324. Janssen Pharmaceutica. Hismanal (astemizole) tablets prescribing information. Titusville, NJ. 1988 Feb.

325. Janssen Pharmaceutica. Titusville, NJ: Personal communication.

326. Dan M, Feigl D. Erythromycin-associated hypotension. Pediatr Infect Dis J. 1993; 12:692. http://www.ncbi.nlm.nih.gov/pubmed/8414782?dopt=AbstractPlus

328. Terfenadine/macrolide antibiotics. In: Tatro DS, Olin BR, Hebel SK eds. Drug interaction facts. St. Louis: JB Lippincott Co; 1993:(April)685b.

329. Anon. Safety of terfenadine and astemizole. Med Lett Drugs Ther. 1992; 34:9-10. http://www.ncbi.nlm.nih.gov/pubmed/1732711?dopt=AbstractPlus

330. Centers for Disease Control and Prevention. Pertussis outbreaks—Massachusetts and Maryland, 1992. MMWR Morb Mortal Wkly Rep. 1993; 42:197-200. http://www.ncbi.nlm.nih.gov/pubmed/8446095?dopt=AbstractPlus

331. American Heart Association, American Dental Association Council on Dental Therapeutics. Preventing bacterial endocarditis: a statement for the dental professional. J Am Dent Assoc. 1991; 122:87-92.

332. Benzodiazepines/macrolide antibiotics. In: Tatro DS, Olin BR, Hebel SK eds. Drug interaction facts. St. Louis: JB Lippincott Co; 1992:(April)131b.

333. Olkkola KT, Aranko K, Luurila H et al. A potentially hazardous interaction between erythromycin and midazolam. Clin Pharmacol Ther. 1993; 53:298-305. http://www.ncbi.nlm.nih.gov/pubmed/8453848?dopt=AbstractPlus

334. Phillips JP, Antal EJ, Smith RB. A pharmacokinetic drug interaction between erythromycin and triazolam. J Clin Psychopharmacol. 1986; 6:297-9. http://www.ncbi.nlm.nih.gov/pubmed/3771812?dopt=AbstractPlus

335. Hiller A, Olkkola KT, Isohanni P et al. Unconsciousness associated with midazolam and erythromycin. Br J Anaesth. 1990; 65:826-8. http://www.ncbi.nlm.nih.gov/pubmed/2265054?dopt=AbstractPlus

336. Abbott Laboratories. Erythrocin lactobionate-I.V. prescribing information. Chicago, IL; 1991 Jan.

337. Ateshkadi A, Lam NP, Johnson CA. Helicobacter pylori and peptic ulcer disease. Clin Pharm. 1993; 12:34-48. http://www.ncbi.nlm.nih.gov/pubmed/8428432?dopt=AbstractPlus

338. Marshall BJ. Treatment strategies for Helicobacter pylori infection. Gastroenterol Clin North Am. 1993; 22:183-98. http://www.ncbi.nlm.nih.gov/pubmed/8449566?dopt=AbstractPlus

339. Marshall BJ. Campylobacter pylori: its link to gastritis and peptic ulcer disease. Clin Infect Dis. 1990; 12(Suppl 1):S87-93.

340. Graham DY, Borösch GM. The who’s and when’s of therapy for Helicobacter pylori. Am J Gastroenterol. 1990; 85:1552-5. http://www.ncbi.nlm.nih.gov/pubmed/2252013?dopt=AbstractPlus

341. Yeung CK, Fu KH, Yuen KY et al. Helicobacter pylori and associated duodenal ulcer. Arch Dis Child. 1990; 65:1212-6. http://www.ncbi.nlm.nih.gov/pubmed/2248531?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1792624&blobtype=pdf

342. Oderda G, Dell’Olio D, Morra I et al. Campylobacter pylori gastritis: long term results of treatment with amoxycillin. Arch Dis Child. 1989; 64:326-9. http://www.ncbi.nlm.nih.gov/pubmed/2495776?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1791940&blobtype=pdf

343. Blaser MJ. Helicobacter pylori: its role in disease. Clin Infect Dis. 1992; 15:386-91. http://www.ncbi.nlm.nih.gov/pubmed/1520782?dopt=AbstractPlus

344. Murray DM, DuPont HL, Cooperstock M et al. Evaluation of new anti-infective drugs for the treatment of gastritis and peptic ulcer disease associated with infection by Helicobacter pylori. Clin Infect Dis. 1992; 15(Suppl 1):S268-73.

346. National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial susceptibility tests: twelfth information supplement. NCCLS document M100-S12. NCCLS: Wayne, PA; 2002 Jan.

347. Centers for Disease Control and Prevention. Update: investigation of bioterrorism-related anthrax and interim guidelines for exposure management and antimicrobial therapy, October 2001. MMWR Morb Mortal Wkly Rep. 2001; 50:909-19. http://www.ncbi.nlm.nih.gov/pubmed/11699843?dopt=AbstractPlus

349. Bromocriptine/erythromycin. In: Tatro DS, Olin BR, Hebel SK, eds. Drug interaction facts. St. Louis: JB Lippincott Co; 1991(Apr):164a.

350. Nelson MV, Berchou RC, Kareti D et al. Pharmacokinetic evaluation of erythromycin and caffeine administered with bromocriptine. Clin Pharmacol Ther. 1990; 47:694-7. http://www.ncbi.nlm.nih.gov/pubmed/2357864?dopt=AbstractPlus

351. Disopyramide/erythromycin. In: Tatro DS, Olin BR, Hebel SK, eds. Drug interaction facts. St. Louis: JB Lippincott Co; 1990(Jul):299a.

352. Mansuy D. Formation of reactive intermediates and metabolites: effects of macrolide antibiotics on cytochrome P-450. Pharmacol Ther. 1987; 33:41-5. http://www.ncbi.nlm.nih.gov/pubmed/3628477?dopt=AbstractPlus

353. Disopyramide (Norpace) interactions: erythromycin. In: Hansten PD, Horn JR, eds. Drug interactions and updates. Vancouver, WA: Applied Therapeutics, Inc.; 1993:163-4.

354. Barkowski RR, McDonnell TE. Prolonged alfentanil effect following erythromycin administration. Anesthesiology. 1990; 73:566-8. http://www.ncbi.nlm.nih.gov/pubmed/2203286?dopt=AbstractPlus

355. Erythromycin interactions: alfentanil (Alfenta). In: Hansten PD, Horn JR, eds. Drug interactions and updates. Vancouver, WA: Applied Therapeutics, Inc.; 1993:221.

356. Erythromycin interactions: bromocriptine (Parlodel). In: Hansten PD, Horn JR, eds. Drug interactions and updates. Vancouver, WA: Applied Therapeutics, Inc.; 1993:223.

357. Erythromycin interactions: cyclosporine (Sandimmune). In: Hansten PD, Horn JR, eds. Drug interactions and updates. Vancouver, WA: Applied Therapeutics, Inc.; 1993:224.

358. Carbamazepine (Tegretol) interactions: erythromycin. In: Hansten PD, Horn JR, eds. Drug interactions and updates. Vancouver, WA: Applied Therapeutics, Inc.; 1993:336.

359. Erythromycin interactions: HMG-CoA reductase inhibitors. In: Hansten PD, Horn JR, eds. Drug interactions and updates. Vancouver, WA: Applied Therapeutics, Inc.; 1993:226.

360. Farrar HC, Walsh Sukys C, Kyllonen K et al. Cardiac toxicity associated with intravenous erythromycin lactobionate: two case reports and a review of the literature. Pediatr Infect Dis J. 1993; 12:688-91. http://www.ncbi.nlm.nih.gov/pubmed/8018130?dopt=AbstractPlus

361. Sims PJ, Waites KB, Crouse DT. Erythromycin lactobionate toxicity in preterm neonates. Pediatr Infect Dis J. 1994; 13:164-5. http://www.ncbi.nlm.nih.gov/pubmed/8190550?dopt=AbstractPlus

362. Farrar HC, Walsh Sukys C, Kyllonen K et al. Erythromycin lactobionate toxicity in preterm neonates. Pediatr Infect Dis J. 1994; 13:166.

363. Anon. Chancroid detected by polymerase chain reaction—Jackson, Mississippi, 1994–1995. MMWR Morb Mortal Wkly Rep. 1995; 44:567, 573-4. http://www.ncbi.nlm.nih.gov/pubmed/7616954?dopt=AbstractPlus

364. Bartlett JG. Antibiotic-associated diarrhea. Clin Infect Dis. 1992; 15:573-81. http://www.ncbi.nlm.nih.gov/pubmed/1420669?dopt=AbstractPlus

365. Fujisawa USA, Inc. Prograf (tacrolimus) prescribing information. Deerfield, IL; 1994 April.

366. Hooks MA. Tacrolimus, a new immunosuppressant—a review of the literature. Ann Pharmacother. 1994; 28:501-11. http://www.ncbi.nlm.nih.gov/pubmed/7518710?dopt=AbstractPlus

367. Klintmalm GB. FK 506: an update. Clin Transplantation. 1994; 8:207-10.

368. Peters DH, Fitton A, Plosker GL et al. Tacrolimus: a review of its pharmacology, and therapeutic potential in hepatic and renal transplantation. Drugs. 1993; 46:746-94. http://www.ncbi.nlm.nih.gov/pubmed/7506654?dopt=AbstractPlus

369. Porayko MK, Wiesner RH, US multicenter FK506 Study Group. US multicenter prospective randomized trial comparing primary immunosuppression with FK506 vs cyclosporine (CyA) following liver transplantation. Gastroenterology. 1993; 104:A974. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=2991095&blobtype=pdf

370. Backman L, Nicar M, Levy M et al. FK506 trough levels in whole blood and plasma in liver transplant recipients. Transplantation. 1994; 57:519-25. http://www.ncbi.nlm.nih.gov/pubmed/7509516?dopt=AbstractPlus

371. Wallemacq PE, Reding R. FK506 (tacrolimus), a novel immunosuppressant in organ transplantation: clinical, biomedical, and analytical aspects. Clin Chem. 1993; 39:22219-28.

372. Anon. Tacrolimus (FK506) for organ transplants. Med Lett Drugs Ther. 1994; 36:82-3. http://www.ncbi.nlm.nih.gov/pubmed/7520968?dopt=AbstractPlus

373. Kino T, Hatanaka H, Hashimoto M et al. FK-506, a novel immunosuppressant isolated from a Streptomyces. I. Fermentation, isolation, and physico-chemical and biological characteristics. J Antibiot (Tokyo). 1987; 40:1249-55. http://www.ncbi.nlm.nih.gov/pubmed/2445721?dopt=AbstractPlus

374. Kino T, Hatanaka H, Miyata S et al. FK-506, a novel immunosuppressant isolated from a Streptomyces. II. Immunosuppressant effect of FK-506 in vitro. J Antibiot (Tokyo). 1987; 40:1256-65. http://www.ncbi.nlm.nih.gov/pubmed/2445722?dopt=AbstractPlus

375. Neuhaus P, Pichlmayr R, Williams R for the European FK506 Multicentre Liver Study Group. Lancet. 1994; 344:423-8. (IDIS 333973)

376. Nattel S, Ranger S, Talajic M et al. Erythromycin-induced long QT syndrome: concordance with quinidine and underlying cellular electrophysiologic mechanism. Am J Med. 1990; 89:235-8. http://www.ncbi.nlm.nih.gov/pubmed/2382671?dopt=AbstractPlus

377. Kelly CP, Pothoulakis C, LaMont JT. Clostridium difficile colitis. N Engl J Med. 1994; 330:257-62. http://www.ncbi.nlm.nih.gov/pubmed/8043060?dopt=AbstractPlus

378. Mesdjian E, Dravet C, Cenraud B et al. Carbamazepine intoxication due to triacetyloleandomycin administration in epileptic patients. Epilepsia. 1980; 21:489-96. http://www.ncbi.nlm.nih.gov/pubmed/6968264?dopt=AbstractPlus

379. Hedrick R, William F, Morin R et al. Carbamazepine-erythromycin interaction leading to carbamazepine toxicity in four epileptic children. Ther Drug Monit. 1983; 5:405-7. http://www.ncbi.nlm.nih.gov/pubmed/6659014?dopt=AbstractPlus

380. Jaster PJ, Abbas D. Erythromycin-carbamazepine interactions. Neurology. 1986; 36:594-5. http://www.ncbi.nlm.nih.gov/pubmed/3960343?dopt=AbstractPlus

381. Goulden KJ, Camfield P, Dooley JM et al. Clinical and laboratory observations: severe carbamazepine intoxication after coadministration of erythromycin. J Pediatr. 1986; 109:135-8. http://www.ncbi.nlm.nih.gov/pubmed/3723233?dopt=AbstractPlus

382. Berrettini WH. A case of erythromycin-induced carbamazepine toxicity. J Clin Psychiatr. 1986; 47:147.

383. Mitsch RA. Carbamazepine toxicity precipitated by intravenous erythromycin. DICP. 1989; 23:878-9. http://www.ncbi.nlm.nih.gov/pubmed/2596129?dopt=AbstractPlus

384. Macnab AJ, Robinson JL, Adderly RJ et al. Heart block secondary to erythromycin-induced carbamazepine toxicity. Pediatrics. 1987; 80:951-3. http://www.ncbi.nlm.nih.gov/pubmed/3684408?dopt=AbstractPlus

385. Wong YY, Ludden TM, Bell RD. Effect of erythromycin on carbamazepine kinetics. Clin Pharmacol Ther. 1983; 33:460-4. http://www.ncbi.nlm.nih.gov/pubmed/6831824?dopt=AbstractPlus

386. Ptachicinski RJ, Carpenter BJ, Burckart GJ et al. Effect of erythromycin on cyclosporine levels. N Engl J Med. 1985; 313:1416-7. http://www.ncbi.nlm.nih.gov/pubmed/4058537?dopt=AbstractPlus

387. Kohan DE. Possible interaction between cyclosporine and erythromycin. N Engl J Med. 1986; 314:448. http://www.ncbi.nlm.nih.gov/pubmed/3511381?dopt=AbstractPlus

388. Freeman DJ, Martell R, Carruthers SG et al. Cyclosporin-erythromycin interaction in normal subjects. Br J Clin Pharmacol. 1987; 23:776-8. http://www.ncbi.nlm.nih.gov/pubmed/3606938?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1386176&blobtype=pdf

389. Godin JRP, Sketris IS, Belitsky P. Erythromycin-cyclosporine interaction. DICP. 1986; 20:504-5.

390. Bartkowski RR, Goldberg ME, Larijani GE et al. Inhibition of alfentanil metabolism by erythromycin. Clin Pharmacol Ther. 1989; 46:99-102. http://www.ncbi.nlm.nih.gov/pubmed/2501060?dopt=AbstractPlus

391. Ayanian JZ, Fuchs SC, Stone RM. Lovastatin and rhabdomyolysis. Ann Intern Med. 1988; 109:682-3. http://www.ncbi.nlm.nih.gov/pubmed/3421582?dopt=AbstractPlus

392. Dajani A, Taubert K, Ferrieri P et al and the American Heart Association Committee on Rheumatic Fever et al. Treatment of acute streptococcal pharyngitis and prevention of rheumatic fever: a statement for health professionals. Pediatrics. 1995; 96:758-64. http://www.ncbi.nlm.nih.gov/pubmed/7567345?dopt=AbstractPlus

393. Spinler SA, Cheng JWM, Kindwall KE et al. Possible inhibition of hepatic metabolism of quinidine by erythromycin. Clin Pharmacol Ther. 1995; 57:89-94. http://www.ncbi.nlm.nih.gov/pubmed/7828386?dopt=AbstractPlus

394. Nocton JJ, Steere AC. Lyme disease. Adv Intern Med. 1995; 40:69-117. http://www.ncbi.nlm.nih.gov/pubmed/7747659?dopt=AbstractPlus

395. Spach DH, Liles WC, Campbell GL et al. Tick-borne diseases in the United States. N Engl J Med. 1993; 329:936-47. http://www.ncbi.nlm.nih.gov/pubmed/8361509?dopt=AbstractPlus

396. Jantausch BA. Lyme disease, Rocky Mountain spotted fever, ehrlichiosis: emerging and established challenges for the clinician. Ann Allergy. 1994; 73:4-11. http://www.ncbi.nlm.nih.gov/pubmed/8030801?dopt=AbstractPlus

397. Nadelman RB, Wormser GP. Erythema migrans and early Lyme disease. Am J Med. 1995; 98(4A):15-23S.

398. Sigal LH. Early disseminated Lyme disease: cardiac manifestations. Am J Med. 1995; 98(4A):25-28S.

399. Steere AC. Musculoskeletal manifestations of Lyme disease. Am J Med. 1995; 98(4A):44-48S.

400. Sigal LH. Management of Lyme disease refractory to antibiotic therapy. Rheum Dis Clin North Am. 1995; 21:217-30. http://www.ncbi.nlm.nih.gov/pubmed/7732170?dopt=AbstractPlus

401. Pachner AR. Early disseminated Lyme disease: Lyme meningitis. Am J Med. 1995; 98(4A):30-37S.

402. Sigal LH. Persisting symptoms of Lyme disease—possible explanations and implications for treatment. J Rheumatol. 1994; 21:593-5. http://www.ncbi.nlm.nih.gov/pubmed/8035381?dopt=AbstractPlus

403. Antihistamines, nonsedating/macrolide antibiotics. In: Tatro DS, Olin BR, Hebel SK, eds. Drug interaction facts. St. Louis: JB Lippincott Co; 1996(July):110d.

404. Peck CC, Temple R, Collins JM. Understanding consequences of concurrent therapies. JAMA. 1993; 269:1550-2. http://www.ncbi.nlm.nih.gov/pubmed/8445821?dopt=AbstractPlus

405. Thompson D, Oster G. Use of terfenadine and contraindicated drugs. JAMA. 1996; 275:1339-41. http://www.ncbi.nlm.nih.gov/pubmed/8614120?dopt=AbstractPlus

406. Honig PK, Woosley RL, Zamani K et al. Changes in the pharmacokinetics and electrocardiographic pharmacodynamics of terfenadine with concomitant administration of erythromycin. Clin Pharmacol Ther. 1992; 52:231-8. http://www.ncbi.nlm.nih.gov/pubmed/1526078?dopt=AbstractPlus

407. Rolf CN. Dear doctor letter regarding important drug warning of Seldane. Cincinnati, OH: Marion Merrell Dow; 1990 Aug 6.

408. Nightingale SL. Warnings issued on nonsedating antihistamines terfenadine and astemizole. JAMA. 1992; 268:705. http://www.ncbi.nlm.nih.gov/pubmed/1322467?dopt=AbstractPlus

409. Anon. New boxed warnings added for Seldane, Hismanal. FDA Med Bull. 1992; 22(Sep):2-3.

410. Peck CC, Temple R, Collins JM. Understanding consequences of concurrent therapies. JAMA. 1993; 269:1550-2. http://www.ncbi.nlm.nih.gov/pubmed/8445821?dopt=AbstractPlus

411. Azithromycin (Zithromax) interactions: terfenadine (Seldane). In: Hansten PD, Horn JR. Drug interactions and updates. Vancouver, WA: Applied Therapies, Inc; 1994:743-4.

412. Honig P, Wortham D, Zamani K et al. Effect of erythromycin, clarithromycin and azithromycin on the pharmacokinetics of terfenadine. Clin Pharmacol Ther. 1993; 53:161.

413. Harris S, Hilligoss DM, Colangelo PM et al. Azithromycin and terfenadine: lack of drug interaction. Clin Pharmacol Ther. 1995; 58:310-5. http://www.ncbi.nlm.nih.gov/pubmed/7554704?dopt=AbstractPlus

414. Muro Pharmaceutical Inc. Dynabac (dirithromycin tablets) prescribing information. Tewksbury, MA: 1999 Oct 11.

415. Centers for Disease Control and Prevention. Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC. MMWR Morb Mortal Wkly Rep. 2002; 51(No. RR-11):1-22. http://www.cdc.gov/mmwr/PDF/rr/rr5111.pdf

416. Pfizer. Zithromax (azithromycin) capsules, tablets, and for oral suspension prescribing information. New York, NY; 2001 Dec.

417. Havlir DV, Dube MP, Sattler FR et al. Prophylaxis against disseminated Mycobacterium avium complex with weekly azithromycin, daily rifabutin, or both. N Engl J Med. 1996; 335:392-8. http://www.ncbi.nlm.nih.gov/pubmed/8676932?dopt=AbstractPlus

418. Horsburg CR Jr. Advances in the prevention and treatment of Mycobacterium avium disease. N Engl J Med. 1996; 335:428-30. http://www.ncbi.nlm.nih.gov/pubmed/8663875?dopt=AbstractPlus

420. US Public Health Service (USPHS) and Infectious Diseases Society of America (IDSA) Prevention of Opportunistic Infections Working Group. 2001 USPHS/IDSA guidelines for the prevention of opportunistic infections in persons with human immunodeficiency virus. From the US Department of Health and Human Services HIV/AIDS Information Services (AIDSinfo) website (http://aidsinfo.nih.gov).

422. Abbott Laboratories. Biaxin (clarithromycin) Filmtab tablets, XL Filmtab extended-release tablets, and granules for oral suspension prescribing information. North Chicago, IL; 2001 Aug.

423. Pierce M, Crampton S, Henry D et al. A randomized trial of clarithromycin as prophylaxis against disseminated Mycobacterium avium complex infection in patients with advanced acquired immunodeficiency syndrome. N Engl J Med. 1996; 335:384-91. http://www.ncbi.nlm.nih.gov/pubmed/8663871?dopt=AbstractPlus

424. Shafran SD, Singer J, Zarowny DP et al. A comparison of two regimens for the treatment of Mycobacterium avium complex bacteremia in AIDS: rifabutin, ethambutol, and clarithromycin versus rifampin, ethambutol, clofazimine, and ciprofloxacin. N Engl J Med. 1996; 335:377-83. http://www.ncbi.nlm.nih.gov/pubmed/8676931?dopt=AbstractPlus

425. Chin DP, Hopewell PC. How to treat bacteraemic Mycobacterium avium complex disease. Lancet. 1995; 346:920-1. http://www.ncbi.nlm.nih.gov/pubmed/7564723?dopt=AbstractPlus

426. Chaisson RE, Benson CA, Dube MP et al. Clarithromycin therapy for bacteremic Mycobacterium avium complex disease. Ann Intern Med. 1994; 121:905-11. http://www.ncbi.nlm.nih.gov/pubmed/7978715?dopt=AbstractPlus

427. Archange YR, Carrey Z, Zanlungo PG. Clarithromycin prophylaxis against disseminated Mycobacterium avium complex in patients with AIDS. J Int Assoc Physicians AIDS Care. 1995; 1:20-2. http://www.ncbi.nlm.nih.gov/pubmed/11362747?dopt=AbstractPlus

429. Peterson WL. Helicobacter pylori and peptic ulcer disease. N Engl J Med. 1991; 324:1043-8. http://www.ncbi.nlm.nih.gov/pubmed/2005942?dopt=AbstractPlus

430. Marshall BJ. Helicobacter pylori. Am J Gastroenterol. 1994; 89:S116-28.

431. Walsh JH, Peterson WL. The treatment of Helicobacter pylori infection in the management of peptic ulcer disease. N Engl J Med. 1995; 333:984-91. http://www.ncbi.nlm.nih.gov/pubmed/7666920?dopt=AbstractPlus

432. Hackelsberger A, Malfertheiner P. A risk-benefit assessment of drugs used in the eradication of Helicobacter pylori infection. Drug Saf. 1996; 15:30-52. http://www.ncbi.nlm.nih.gov/pubmed/8862962?dopt=AbstractPlus

433. Rauws EAJ, van der Hulst RWM. Current guidelines for the eradication of Helicobacter pylori in peptic ulcer disease. Drugs. 1995; 6:984-90.

434. Dunn CJ, Barradell LB. Azithromycin: a review of its pharmacological properties and use as 3-day therapy in respiratory tract infections. Drugs. 1996; 51:483-505. http://www.ncbi.nlm.nih.gov/pubmed/8882383?dopt=AbstractPlus

435. Schentag JJ. Antibiotic treatment of acute otitis media in children: dosing considerations. Pediatr Infect Dis J. 1995; 14:S30-3.

436. Dajani AS, Taubert KA, Wilson W et al. Prevention of bacterial endocarditis: recommendations by the American Heart Association. JAMA. 1997; 277:1794-1801. http://www.ncbi.nlm.nih.gov/pubmed/9178793?dopt=AbstractPlus

437. Durack DT, Kaplan EL, Bisno AL. Apparent failures of endocarditis prophylaxis: analysis of 52 cases submitted to a national registry. JAMA. 1983; 250:2318-22. http://www.ncbi.nlm.nih.gov/pubmed/6632128?dopt=AbstractPlus

439. Klausner MA. Dear doctor letter regarding important drug warning of Hismanal (astemizole). Titusville, NJ: Janssen Pharmaceutica; 1998 Feb.

440. Seppala H, Klaukka T, Vuopio-Varkila J et al. The effect of changes in the consumption of macrolide antibiotics on erythromycin resistance in group A streptococci in Finland. N Engl J Med. 1997; 337:441-6. http://www.ncbi.nlm.nih.gov/pubmed/9250845?dopt=AbstractPlus

441. Bisno AL, Gerber MA, Gwaltney JM et al. Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Clin Infect Dis. 2002; 35:113-25. http://www.ncbi.nlm.nih.gov/pubmed/12087516?dopt=AbstractPlus

442. Wu JJ, Lin KY, Hsueh PR et al. High incidence of erythromycin-resistant streptococci in Taiwan. Antimicrob Agents Chemother. 1997; 41:844-6. http://www.ncbi.nlm.nih.gov/pubmed/9087502?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=163807&blobtype=pdf

443. Hsueh PR, Chen HM, Huang AH et al. Decreased activity of erythromycin against Streptococcus pyogenes in Taiwan. Antimicrob Agents Chemother. 1995; 39:2239-42. http://www.ncbi.nlm.nih.gov/pubmed/8619575?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=162922&blobtype=pdf

444. Orden B, Perez-Trallero E, Montes M et al. Erythromycin resistance of Streptococcus pyogenes in Madrid. Pediatr Infect Dis J. 1998; 17:470-3. http://www.ncbi.nlm.nih.gov/pubmed/9655536?dopt=AbstractPlus

445. Pearlman MD, Pierson CL, Faix RG. Frequent resistance of clinical group B streptococci isolates to clindamycin and erythromycin. Obstet Gynecol. 1998; 92:258-61. http://www.ncbi.nlm.nih.gov/pubmed/9699763?dopt=AbstractPlus

446. Carroll KC, Monroe P, Cohen S et al. Susceptibility of beta-hemolytic streptococci to nine antimicrobial agents among four medical centers in Salt Lake City, Utah, USA. Diagn Microbiol Infect Dis. 1997; 27:123-8. http://www.ncbi.nlm.nih.gov/pubmed/9154408?dopt=AbstractPlus

447. Sutcliffe J, Tait-Kamradt A, Wondrack L. Streptococcus pneumoniae and Streptococcus pyogenes resistant to macrolides but sensitive to clindamycin: a common resistance pattern mediated by an efflux system. Antimicrob Agents Chemother. 1996; 40:1817-24. http://www.ncbi.nlm.nih.gov/pubmed/8843287?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=163423&blobtype=pdf

448. Doern GV, Ferraro MJ, Brueggemann AB et al. Emergence of high rates of antimicrobial resistance among viridans group streptococci in the United States. Antimicrob Agents Chemother. 1996; 40:891-4. http://www.ncbi.nlm.nih.gov/pubmed/8849246?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=163225&blobtype=pdf

449. Fernandez M, Hickman ME, Baker CJ. Antimicrobial susceptibilities of group B streptococci isolated between 1992 and 1996 from patients with bacteremia or meningitis. Antimicrob Agents Chemother. 1998; 42:1517-9. http://www.ncbi.nlm.nih.gov/pubmed/9624508?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=105636&blobtype=pdf

450. Hart G. Donovanosis. Clin Infect Dis. 1997; 25:24-32. http://www.ncbi.nlm.nih.gov/pubmed/9243028?dopt=AbstractPlus

451. Centers for Disease Control and Prevention. Compendium of measures to control Chlamydia psittaci infection among humans (psittacosis) and pet birds (avian chlamydiosis), 2000. MMWR Morb Mortal Wkly Rep. 2000; 49(No. RR-8):1-17. http://www.ncbi.nlm.nih.gov/pubmed/10993565?dopt=AbstractPlus http://www.cdc.gov/mmwr/PDF/rr/rr4908.pdf

452. Stout JE, Yu VL. Legionellosis. N Engl J Med. 1997; 337:682-7. http://www.ncbi.nlm.nih.gov/pubmed/9278466?dopt=AbstractPlus

453. Edelstein PH. Legionnaires’ disease. Clin Infect Dis. 1993; 16:741-9. http://www.ncbi.nlm.nih.gov/pubmed/8329504?dopt=AbstractPlus

454. Farizo KM, Strebel PM, Chen RT et al. Fatal respiratory disease due to Corynebacterium diphtheriae: case report and review of guidelines for management, investigation, and control. Clin Infect Dis. 1993; 16:59-68. http://www.ncbi.nlm.nih.gov/pubmed/8448320?dopt=AbstractPlus

455. Centers for Disease Control Immunization Practices Advisory Committee (ACIP). Diphtheria, tetanus, and pertussis: recommendations for vaccine use and other preventive measures. MMWR Morb Mortal Wkly Rep. 1991; 40(No. RR-10):1-28. http://www.ncbi.nlm.nih.gov/pubmed/1898620?dopt=AbstractPlus

456. Anon. Transmission of pertussis from adult to infant—Michigan, 1993. MMWR Morb Mortal Wkly Rep. 1995; 44:74-6. http://www.ncbi.nlm.nih.gov/pubmed/7830704?dopt=AbstractPlus

457. Lewis K, Saubolle MA, Tenover FC et al. Pertussis caused by an erythromycin-resistant strain of Bordetella pertussis. Pediatr Infect Dis J. 1995; 14:388-91. http://www.ncbi.nlm.nih.gov/pubmed/7638015?dopt=AbstractPlus

458. Halperin SA, Bortolussi R, Langley JM et al. Seven days of erythromycin estolate is as effective as fourteen days for the treatment of Bordetella pertussis infections. Pediatrics. 1997; 100:65-71. http://www.ncbi.nlm.nih.gov/pubmed/9200361?dopt=AbstractPlus

459. Leyden JJ. Therapy for acne vulgaris. N Engl J Med. 1997; 336:1156-62. http://www.ncbi.nlm.nih.gov/pubmed/9099661?dopt=AbstractPlus

460. Spach DH, Kanter AS, Dougherty MJ et al. Bartonella (Rochalimaea) quintana bacteremia in inner-city patients with chronic alcoholism. N Engl J Med. 1995; 332:424-8. http://www.ncbi.nlm.nih.gov/pubmed/7529895?dopt=AbstractPlus

461. Brouqui P, Houpikian P, Dupont HT et al. Survey of seroprevalence of Bartonella quintana in homeless people. Clin Infect Dis. 1996; 23:756-9. http://www.ncbi.nlm.nih.gov/pubmed/8909840?dopt=AbstractPlus

462. Spach DH, Koehler JE. Bartonella-associated infections. Infect Dis Clin N Am. 1998; 12:137-55.

463. Bass JW, Vincent JM, Person DA. The expanding spectrum of Bartonella infections: I. Bartonellosis and trench fever. Pediatr Infect Dis J. 1997; 16:2-10. http://www.ncbi.nlm.nih.gov/pubmed/9002093?dopt=AbstractPlus

464. Tan JS. Human zoonotic infections transmitted by dogs and cats. Arch Intern Med. 1997; 157:1933-43. http://www.ncbi.nlm.nih.gov/pubmed/9308505?dopt=AbstractPlus

465. Bass JW, Freitas BC, Freitas AD et al. Prospective randomized double blind placebo-controlled evaluation of azithromycin for treatment of cat-scratch disease. Pediatr Infect Dis J. 1998; 17:447-52. http://www.ncbi.nlm.nih.gov/pubmed/9655532?dopt=AbstractPlus

466. Smith DL. Cat-scratch disease and related clinical syndromes. Am Fam Physician. 1997; 55:1783-9. http://www.ncbi.nlm.nih.gov/pubmed/9105205?dopt=AbstractPlus

467. Johnson S, Gerding DN. Clostridium difficile-associated diarrhea. Clin Infect Dis. 1998; 26:1027-36. http://www.ncbi.nlm.nih.gov/pubmed/9597221?dopt=AbstractPlus

468. Gerding DN, Johnson S, Peterson LR et al for the Society for Healthcare Epidemiology of American. Position paper on Clostridium difficile-associated diarrhea and colitis. Infect Control Hosp Epidemiol. 1995; 16:459-77. http://www.ncbi.nlm.nih.gov/pubmed/7594392?dopt=AbstractPlus

469. Fekety R for the American College of Gastroenterology Practice Parameters Committee. Guidelines for the diagnosis and management of Clostridium difficile-associated diarrhea and colitis. Am J Gastroenterol. 1997; 92:739-50 (IDIS 386628) http://www.ncbi.nlm.nih.gov/pubmed/9149180?dopt=AbstractPlus

470. American Society of Health-System Pharmacists Commission on Therapeutics. ASHP therapeutic position statement on the preferential use of metronidazole for the treatment of Clostridium difficile-associated disease. Am J Health-Syst Pharm. 1998; 55:1407-11. http://www.ncbi.nlm.nih.gov/pubmed/9659970?dopt=AbstractPlus

471. Wilcox MH. Treatment of Clostridium difficile infection. J Antimicrob Chemother. 1998; 41(Suppl C):41-6. http://www.ncbi.nlm.nih.gov/pubmed/9630373?dopt=AbstractPlus

472. Anon. The choice of antibacterial drugs. Med Lett Drugs Ther. 2001; 43:69-78. http://www.ncbi.nlm.nih.gov/pubmed/11518876?dopt=AbstractPlus

473. Nadelman RB, Wormser GP. Lyme borreliosis. Lancet. 1998; 352:557-65. http://www.ncbi.nlm.nih.gov/pubmed/9716075?dopt=AbstractPlus

474. Eckman MH, Steere AC, Kalish RA et al. Cost effectiveness of oral as compared with intravenous antibiotic treatment for patients with early Lyme disease or Lyme arthritis. N Engl J Med. 1997; 337:357-63. http://www.ncbi.nlm.nih.gov/pubmed/9233874?dopt=AbstractPlus

475. Anon. Treatment of Lyme Disease. Med Lett Drugs Ther. 2000; 42:37-9. http://www.ncbi.nlm.nih.gov/pubmed/10825919?dopt=AbstractPlus

476. Luft BJ, Dattwyler RJ, Johnson RC et al. Azithromycin compared with amoxicillin in the treatment of erythema migrans. Ann Intern Med. 1996; 124:785-91. http://www.ncbi.nlm.nih.gov/pubmed/8610947?dopt=AbstractPlus

477. Rahn DW, Felz MW. Lyme disease update. Current approach to early, disseminated, and late disease. Postgrad Med. 1998; 103:51-4, 57-9, 63-4. http://www.ncbi.nlm.nih.gov/pubmed/9590986?dopt=AbstractPlus

478. Dattwyler RJ, Grunwaldt E, Luft BJ. Clarithromycin in treatment of early Lyme disease: a pilot study. Antimicrob Agents Chemother. 1996; 40:468-9. http://www.ncbi.nlm.nih.gov/pubmed/8834900?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=163136&blobtype=pdf

479. Janssen Pharmaceutica. Propulsid (cisapride monohydrate) tablets and suspension prescribing information. Titusville, NJ: 1998 Sep.

480. Sekkarie MA. Torsades de pointes in two chronic renal failure patients treated with cisapride and clarithromycin. Am J Kidney Dis. 1997; 30:437-9. http://www.ncbi.nlm.nih.gov/pubmed/9292575?dopt=AbstractPlus

481. Ray WA, Murray KT, Meredith S et al. Oral erythromycin and the risk of sudden death from cardiac causes. N Engl J Med. 2004; 351:1089-96. http://www.ncbi.nlm.nih.gov/pubmed/15356306?dopt=AbstractPlus

482. Paine MF, Wagner DA, Hoffmaster KA, Watkins PB. Cytochrome P450 3A4 and P-glycoprotein mediate the interaction between an oral erythromycin breast test and rifampin. Clin Pharmacol Ther. 2002: 72:524-35.

483. American Academy of Pediatrics Subcommittee on Management of Acute Otitis Media. Diagnosis and management of acute otitis media. Pediatrics. 2004: 113:1451-65.

a. AHFS Drug Information 2004. McEvoy GK, ed. Erythromycins General Statement. Bethesda, MD: American Society of Health-System Pharmacists; 2004:216-25.

b. Abbott. PCE dispertab (erythromycin) tablets prescribing information. North Chicago, IL: 2002 Jun.

c. Abbott. Erythrocin lactobionate-IV (erythromycin lactobionate) prescribing information. North Chicago, IL: 2000.

d. Abbott. Erythromycin base filmtab (erythromycin) tablets prescribing information. North Chicago, IL: 2000 Oct.

e. Abbott. Erythromycin delayed-release capsules prescribing information. North Chicago, IL: 1991 Sept.

f. Abbott. EryPed 200 & EryPed 400, EryPed drops, EryPed chewable tablets (erythromycin ethylsuccinate) prescribing information. North Chicago, IL: 2002 Jun.

HID. Trissel LA. Handbook on injectable drugs. 13th ed. Bethesda, MD: American Society of Health-System Pharmacists; 2003:576-582.

h. AHFS Drug Information 2004. McEvoy GK, ed. Erythromycin. Bethesda, MD: American Society of Health-System Pharmacists; 2004:225-7.

i. AHFS Drug Information 2004. McEvoy GK, ed. Erythromycin Estolate. Bethesda, MD: American Society of Health-System Pharmacists; 2004:227-8.

Frequently Asked Questions

Medical Disclaimer

Drugs.com Mobile Apps

The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Available for Android and iOS devices.

Explore Apps