It is a macrolide antibiotic produced naturally by the
soil bacteria Saccharopolyspora erythraea. It belongs to the class of macrolide
antibiotics which contain a large lactone ring. It is commonly used for
treating various bacterial infections affecting respiratory tract, skin, soft
tissue, and some sexually transmitted diseases.
Mechanism of Action
It acts by inhibiting protein synthesis in susceptible bacteria. It binds to
the 50S subunit of the bacterial ribosome and inhibits transpeptidation and
translocation steps of protein synthesis. This prevents assembling of amino
acids into functional proteins required by the bacteria for its growth and
survival. It is mainly bacteriostatic but can also exhibit bactericidal effects
at higher concentrations.
Spectrum of Antimicrobial Activity
It has activity against many Gram-positive bacteria including Streptococcus,
Staphylococcus, Clostridium, Listeria, Mycoplasma, Legionella, Ureaplasma etc.
It also has some activity against certain Gram-negative bacteria like
Campylobacter, Bordetella, Haemophilus, Legionella, Neisseria, etc. It is
commonly used to treat respiratory tract infections caused by Streptococcus
pneumoniae and Mycoplasma pneumoniae. It is also effective against skin and
soft tissue infections caused by Staphylococcus and Streptococcus species.
Medically Important Indications
Some common medical conditions where
Erythromycin
is prescribed include:
- Upper and lower respiratory tract infections like pneumonia, tonsillitis,
sinusitis, bronchitis etc. caused by erythromycin-sensitive bacteria.
- Sexually transmitted infections like chlamydia, mycoplasma, ureaplasma.
- Skin and soft tissue infections like impetigo, cellulitis, wound infections
etc.
- Enteric (gastrointestinal) infections caused by Campylobacter.
- Other infections like Legionnaire's disease, Lyme disease, brucellosis etc.
Administration and Dosage
It is available in many pharmaceutical formulations for oral and parenteral
administration. The oral formulations include tablets, capsules, granules,
syrup etc. while injectable formulations are used for parenteral
administration. The usual adult dose of erythromycin is 250-500 mg, four times
daily. For children, the dose is calculated based on body weight. The therapy
duration depends on the type and severity of infection but commonly it is
administered for 7-10 days.
Adverse Effects and Drug Interactions
Common adverse effects of it include nausea, vomiting, diarrhea, abdominal
pain. Allergic reactions involving skin rash may also occur. Use of
erythromycin with some drugs increases the risk of cardiac issues like
prolongation of QT interval. It should not be co-administered with drugs that
are metabolized by CYP3A4 due to risk of drug interactions. Food intake during
it therapy decreases its absorption and
bioavailability. Hence, it is generally recommended to take it on an empty
stomach.
A Widely Used Macrolide
it is an orally active macrolide antibiotic that remains useful for
treating numerous bacterial infections. It offers advantages like efficacy
against respiratory tract pathogens and coverage against atypical organisms
like Mycoplasma and Legionella. Despite a few limitations, erythromycin
continues to play an important role in antimicrobial therapy owing to its
excellent safety profile, low cost and extensive clinical experience over many
years. Judicious use of this broad-spectrum macrolide maintains its clinical
effectiveness for management of infectious diseases.
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