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Erythromycin
⚠️ Myopathy risk with simvastatin → stop statins concurrently. Erythromycin is a macrolide antibiotic, often used as an alternative in penicillin allergy. Always check the BNF or local guidelines before prescribing.
💊 Action
- Binds to the 50S ribosomal subunit.
- Inhibits bacterial protein synthesis (bacteriostatic, can be bactericidal at high concentrations).
📌 Properties
- Penetrates most tissues but not CSF.
- Short half-life (~1.5 hours).
- 14-membered macrolide ring → potent CYP3A4 inhibitor.
🎯 Indications
- Respiratory infections (e.g., pneumonia, pertussis, Legionella).
- Chlamydia trachomatis, Campylobacter, diphtheria.
- Skin infections, acne, rosacea.
- Alternative to penicillin in allergy (e.g., streptococcal infections).
⚠️ Interactions
- Inhibits CYP450 → ↑ toxicity of carbamazepine, ciclosporin, digoxin, theophylline, warfarin, methylprednisolone.
- QT prolongation & arrhythmias with terfenadine, astemizole, quinine.
- Do not co-prescribe with simvastatin (risk of myopathy/rhabdomyolysis).
🚫 Contraindications
- Hypersensitivity to macrolides.
⚠️ Cautions
- Known QT prolongation or co-prescription with QT-prolonging drugs.
- Liver disease, renal impairment, acute porphyria.
- Use with caution in pregnancy & breastfeeding (seek specialist advice).
💥 Side Effects
- GI upset: anorexia, nausea, vomiting, dyspepsia, diarrhoea.
- Skin rashes, rare severe reactions: Stevens–Johnson syndrome, TEN.
- Hepatobiliary: acute cholestatic jaundice, pancreatitis.
- Cardiac: QT prolongation, arrhythmias.
💊 Typical Doses – Erythromycin (BNF check essential)
| Indication | Dose |
|---|---|
| 🦠 Infections (PO) | 250 mg – 1 g four times daily |
| 💉 Infections (IV) | 12.5 mg/kg four times daily |
| ⚧ Chlamydia (PO) | 500 mg twice daily × 2 weeks |
📚 References
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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