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Erythromycins

Erythromycins

Definition

Erythromycins, also called macrolides, are a group of antibiotics , medicines that kill bacteria or prevent their growth.

Description

The antibiotics in this group are:

  • azithromycin (Zithromax)
  • clarithromycin (Biaxin)
  • clindamycin (Cleocin)
  • erythromycin (EES, Pediazole)
  • lincomycin (Lincocin)

These drugs are chemically related and have similar uses, but because they are distributed differently in the body, they may be used for different purposes. There are other, older drugs in this group, but they are no longer in general use.

General use

Erythromycin is similar in use to penicillin and is widely used for patients who are allergic to penicillin. Penicillin has advantages over erythromycin in that it kills bacteria, while erythromycin only stops bacterial growth and relies on the body's immune system to kill bacteria. Also, erythromycin is more likely to cause stomach upset than is penicillin. Sometimes erythromycin may be used to treat a microorganism that is resistant to penicillin.

Azithromycin and clarithromycin both reach the lungs and respiratory tract better than does erythromycin. These two drugs may be preferred for respiratory tract infections.

Clindamycin and lincomycin are similar to each other and are more effective than erythromycin for treatment of infections caused by anaerobic bacteria. Anaerobic bacteria can grow in the absence of oxygen.

Precautions

Symptoms should begin to improve within a few days of beginning to take this medicine. If they do not, or if they get worse, parents should check with the physician who prescribed the medicine.

Erythromycins may cause mild diarrhea that usually goes away during treatment. However, severe diarrhea could be a sign of a very serious side effect. Anyone who develops severe diarrhea while taking erythromycin or related drugs should stop taking the medicine and call a physician immediately.

Side effects

The most common side effects are mild diarrhea, nausea , vomiting , and stomach or abdominal cramps. These problems usually go away as the body adjusts to the drug and do not require medical treatment. Less common side effects, such as sore mouth or tongue and vaginal itching and discharge also may occur and do not need medical attention unless they persist or are bothersome.

More serious side effects are not common but may occur. If any of the following side effects occurs, check with a physician immediately:

  • severe stomach pain , nausea, vomiting, or diarrhea
  • fever
  • skin rash, redness, or itching
  • unusual tiredness or weakness

Although rare, very serious reactions to azithromycin (Zithromax) are possible, including extreme swelling of the lips, face, and neck, and anaphylaxis (a violent allergic reaction which can potentially include shock). If children develop these symptoms after taking azithromycin, they should stop taking the medicine and parents should get them immediate medical help.

Other rare side effects may occur with erythromycins and related drugs.

Interactions

Erythromycins may interact with many other medicines. When interaction happens, the effects of one or both of the drugs may change or the risk of side effects may be greater. Parents of children taking erythromycins should let the physician know all other medicines their children are taking. Among the drugs that may interact with erythromycins are:

  • acetaminophen (Tylenol)
  • medicine for overactive thyroid
  • male hormones (androgens)
  • female hormones (estrogens)
  • other antibiotics
  • blood thinners
  • antiseizure medicines such as valproic acid (Depakote, Depakene)
  • caffeine
  • antihistamine such as astemizole (Hismanal)
  • antiviral drugs such as zidovudine (Retrovir)

The list above does not include every drug that may interact with erythromycins. Parents should be sure to check with a physician or pharmacist before combining erythromycins with any other prescription or nonprescription (over-the-counter) medicine.

Some of the stomach upset caused by erythromycin can be minimized by changing the dosage form. Erythromycin is available as enteric-coated tablets, which are released in the intestine rather than the stomach; as a liquid; and as bead-filled capsules. These forms are less likely to cause stomach upset than traditional tablets.

Parental concerns

If a child has had an allergic reaction to erythromycin or any of its related drugs, the prescriber should be notified.

It is very important for patients to take erythromycins for as long as they have been prescribed. Patients must not stop taking the drug just because symptoms begin to improve. This point is important with all types of infections, but it is especially important in strep infections, which can lead to serious heart problems if they are not cleared up completely.

Erythromycins work best when they are at constant levels in the blood. To help keep levels constant, patients should take the medicine in doses spaced evenly through the day and night. No doses should be missed. Some of these medicines are most effective when taken with a full glass of water on an empty stomach, but they may be taken with food if stomach upset is a problem. Others work equally well when taken with or without food. Check package directions or ask the physician or pharmacist for instructions on how to take the medicine.

Liquid forms of erythromycin should be administered with a medicinal teaspoon or other measuring device. Household teaspoons vary in size and may give either too much or too little of the medication.

Bead-filled capsules may be opened and sprinkled on pudding or applesauce for ease of administration. Enteric-coated tablets should never be split or crushed, since doing so will destroy the effectiveness of the coating.

Parents should never ask physicians to prescribe antibiotics for children's illnesses. Antibiotics are important for appropriate infections but are seriously overprescribed. Overuse leads to needless expense for the parents, some discomfort and risk for the child, and the development of antibiotic-resistant bacteria, which have become a public health problem.

Children have complained about the bitter taste of clarithromycin oral liquid. This factor should not be considered a problem. Liquid medications that taste good may be mistaken for candy or sweets, and children may overdose themselves. All medications should be kept away from children.

KEY TERMS

Anaphylaxis Also called anaphylactic shock; a severe allergic reaction characterized by airway constriction, tissue swelling, and lowered blood pressure.

Enteric coating A coating or shell placed on a tablet that breaks up and releases the medicine into the intestine rather than the stomach.

Microorganism An organism that is too small to be seen with the naked eye, such as a bacterium, virus, or fungus.

Respiratory system The organs that are involved in breathing: the nose, the throat, the larynx, the trachea, the bronchi and the lungs. Also called the respiratory tract.

See also Pneumonia; Penicillins.

Resources

BOOKS

Behrman Richard, Robert M. Kliegman, and Hal B. Jenson. Nelson Textbook of Pediatrics, 17th ed. Philadelphia: Saunders, 2003.

Mcevoy, Gerald K., et al. AHFS Drug Information 2004. Bethesda, MD: American Society of Healthsystems Pharmacists, 2004.

Siberry, George, and Robert Iannone, eds. The Harriet Lane Handbook, 15th ed. Philadelphia: Mosby, 2000.

PERIODICALS

Cunha, B. A. "Therapeutic implications of antibacterial resistance in community-acquired respiratory tract infections in children." Infection 32, no. 2 (April 2004): 98108.

Gonzalez, B. E., et al. "Azithromycin compared with betalactam antibiotic treatment failures in pneumococcal infections of children." Pediatric Infectious Diseases Journal 23, no. 5 (May 2004): 399405.

McIsaac, W. J., and T. To. "Antibiotics for lower respiratory tract infections: Still too frequently prescribed?" Canadian Family Physician 50 (April 2004): 569575.

ORGANIZATIONS

American Academy of Pediatrics. 141 Northwest Point Boulevard, Elk Grove Village, IL 600071098. Web site: <www.aap.org>.

Office of Health Communication National Center for Infectious Diseases, Centers for Disease Control and Prevention. Mailstop C-14, 1600 Clifton Road Atlanta, GA 30333. Web site: <www.cdc.gov>.

WEB SITES

"Macrolides." Available online at <www.healthwell.com/healthnotes/healthnotes.cfm?ContentID=1430001> (accessed September 29, 2004.)

Nancy Ross-Flanigan Samuel Uretsky, PharmD

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"Erythromycins." Gale Encyclopedia of Children's Health: Infancy through Adolescence. . Encyclopedia.com. 23 Aug. 2017 <http://www.encyclopedia.com>.

"Erythromycins." Gale Encyclopedia of Children's Health: Infancy through Adolescence. . Encyclopedia.com. (August 23, 2017). http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/erythromycins-1

"Erythromycins." Gale Encyclopedia of Children's Health: Infancy through Adolescence. . Retrieved August 23, 2017 from Encyclopedia.com: http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/erythromycins-1

Erythromycins

Erythromycins

Definition

Erythromycins are medicines that kill bacteria or prevent their growth.


Purpose

Erythromycins are antibiotics , medicines used to treat infections caused by microorganisms. Physicians prescribe these drugs for many types of infections caused by bacteria, including strep throat, sinus infections, pneumonia, ear infections, tonsillitis, bronchitis, gonorrhea, pelvic inflammatory disease (PID), and urinary tract infections. Some medicines in this group are also used to treat Legionnaires' disease and ulcers caused by bacteria. These drugs will not work for colds, flu, and other infections caused by viruses.

Drugs in the erythromycin group may be used to eliminate such areas of infection as abscesses prior to surgery. For this purpose, they have been used in dentistry, eye surgery, and intestinal surgery. In some cases, erythromycin has been used to treat brain abscesses.


Description

The drugs described here include erythromycins (Erythrocin, Ery-C, E-Mycin, and other brands) and such medicines that are chemically related to erythromycins as azithromycin (Zithromax) and clarithromycin (Biaxin). They are available only with a physician's prescription and are sold in capsule, tablet (regular and chewable), liquid, and injectable forms.

Recommended dosage

The recommended dosage depends on the type of erythromycin, the strength of the medicine, and the medical problem for which it is being taken. The person should check with the physician who prescribed the drug or the pharmacist who filled the prescription for the correct dosage.

The patient must always take erythromycins exactly as directed. The patient should never take larger, smaller, more frequent, or less frequent doses. To make sure the infection clears up completely, it is very important to take the medicine for as long as it has been prescribed. Patients must not stop taking the drug just because symptoms begin to improve. This is important with all types of infections, but it is especially important in streptococcal infections, which can lead to serious heart problems if they are not cleared up completely.

Erythromycins work best when they are at constant levels in the blood. To help keep levels constant, the medicine should be taken in doses spaced evenly through the day and night. The patient must not miss any doses. Some of these medicines are most effective when taken with a full glass of water on an empty stomach, but they may be taken with food if stomach upset is a problem. Others work equally well when taken with or without food. Patients should check package directions or ask the physician or pharmacist for instructions on how to take the medicine.


Precautions

There are warnings and cautions that apply to erythromycin and its related drugs when they are taken by mouth over a period of several days. These warnings may not apply when erythromycin is given intravenously (by vein), or as a single dose prior to or immediately after surgery.

Symptoms should begin to improve within a few days of beginning to take this medicine. If they do not, or if they get worse, the patient should check with the physician who prescribed the medicine.

Erythromycins may cause mild diarrhea, which usually goes away during treatment. Severe diarrhea, however, could be a sign of a very serious side effect. Anyone who develops severe diarrhea while taking erythromycin or related drugs should stop taking the medicine and call a physician immediately.

Special conditions

Taking erythromycins may cause problems for people with certain medical conditions or people who are taking certain other medicines. Before taking these drugs, the patient should tell the physician about any of these conditions.

allergies. Anyone who has had unusual reactions to erythromycins, azithromycin, or clarithromycin in the past should let the physician know before taking the drugs again. The physician should also be told about any allergies to foods, dyes, preservatives, or other substances.

pregnancy. Some medicines in this group may cause problems in pregnant women and have the potential to cause birth defects. Women who are pregnant or who may become pregnant should check with their physicians before taking these drugs.

breastfeeding. Erythromycins pass into breast milk. Mothers who are breastfeeding and who need to take this medicine should check with their physicians.

other medical conditions. Before using erythromycins, people with any of these medical problems should make sure their physicians are aware of their conditions:

  • heart disease
  • liver disease
  • hearing loss

use of certain medicines. Taking erythromycins with certain other drugs may affect the way the drugs work or may increase the chance of side effects.


Side effects

The most common side effects are mild diarrhea, nausea, vomiting, and stomach or abdominal cramps. These problems usually go away as the body adjusts to the drug and do not require medical treatment. Less common side effects, such as sore mouth or tongue and vaginal itching and discharge also may occur. They do not need medical attention unless they persist or are bothersome.

More serious side effects are not common, but may occur. If any of the following side effects occur, the patient is advised to check with a physician immediately:

  • severe stomach pain, nausea, vomiting, or diarrhea
  • fever
  • skin rash, redness, or itching
  • unusual tiredness or weakness

Although rare, very serious reactions to azithromycin (Zithromax) are possible, including extreme swelling of the lips, face, and neck; and anaphylaxis (a violent allergic reaction). Anyone who develops these symptoms after taking azithromycin should stop taking the medicine and get immediate medical help.

Other rare side effects may occur with erythromycins and related drugs. Anyone who has unusual symptoms after taking these medicines should get in touch with the physician.


Interactions

Erythromycins may interact with many other medicines. When an interaction occurs, the effects of one or both of the drugs may change or the risk of side effects may be greater. Anyone who takes erythromycins should let the physician know all other medicines he or she is taking. The drugs that may interact with erythromycins include:

  • acetaminophen (Tylenol)
  • medicine for overactive thyroid
  • male hormones (androgens)
  • female hormones (estrogens)
  • other antibiotics
  • blood thinners
  • disulfiram (Antabuse), used to treat alcohol abuse
  • such anti-seizure medicines as valproic acid (Depakote, Depakene)
  • caffeine
  • the antihistamines astemizole (Hismanal)
  • such antiviral drugs as zidovudine (Retrovir)

The list above does not include every drug that may interact with erythromycins. A physician or pharmacist should be consulted before combining erythromycins with any other prescription or nonprescription (over-thecounter) medicine.


Resources

books

ahfs: drug information. washington, dc: american society of healthsystems pharmaceuticals, 2002.

brody, t.m., j. larner, k.p. minneman, and h.c. neu. human pharmacology molecular to clinical, 2nd ed. st. louis: mosby year-book, 1998.

karch, a.m. lippincott's nursing drug guide. springhouse, pa: lippincott williams & wilkins, 2003.

reynolds, j.e.f., ed. martindale the extra pharmacopoeia, 31st ed. london: the pharmaceutical press, 1993.


periodicals

steps to keep antibiotics working effectively. tufts university health & nutrition letter. medford, ma: tufts university, may 2003.


other

"erythromycin." medline plus drug information. [cited may 2003) <http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682381.html>.

"erythromycins (systemic)." medline plus drug information. [cited may 2003) <http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202223.html>.


Nancy Ross-Flanigan Sam Uretsky

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"Erythromycins." Gale Encyclopedia of Surgery: A Guide for Patients and Caregivers. . Encyclopedia.com. 23 Aug. 2017 <http://www.encyclopedia.com>.

"Erythromycins." Gale Encyclopedia of Surgery: A Guide for Patients and Caregivers. . Encyclopedia.com. (August 23, 2017). http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/erythromycins-0

"Erythromycins." Gale Encyclopedia of Surgery: A Guide for Patients and Caregivers. . Retrieved August 23, 2017 from Encyclopedia.com: http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/erythromycins-0

Erythromycins

Erythromycins

Definition

Erythromycins are medicines that kill bacteria or prevent their growth.

Purpose

Erythromycins are antibiotics, medicines used to treat infections caused by microorganisms. Physicians prescribe these drugs for many types of infections caused by bacteria, including strep throat, sinus infections, pneumonia, ear infections, tonsillitis, bronchitis, gonorrhea, pelvic inflammatory disease (PID), and urinary tract infections. Some medicines in this group are also used to treat Legionnaires' disease and ulcers caused by bacteria. These drugs will not work for colds, flu, and other infections caused by viruses.

Description

The drugs described here include erythromycins (Erythrocin, Ery-C, E-Mycin, and other brands) and medicines that are chemically related to erythromycins, such as azithromycin (Zithromax) and clarithromycin (Biaxin). They are available only with a physician's prescription and are sold in capsule, tablet (regular and chewable), liquid, and injectable forms.

Recommended dosage

The recommended dosage depends on the type of erythromycin, the strength of the medicine, and the medical problem for which it is being taken. Check with the physician who prescribed the drug or the pharmacist who filled the prescription for the correct dosage.

Always take erythromycins exactly as directed. Never take larger, smaller, more frequent, or less frequent doses. To make sure the infection clears up completely, it is very important to take the medicine for as long as it has been prescribed. Do not stop taking the drug just because symptoms begin to improve. This is important with all types of infections, but it is especially important in "strep" infections, which can lead to serious heart problems if they are not cleared up completely.

Erythromycins work best when they are at constant levels in the blood. To help keep levels constant, take the medicine in doses spaced evenly through the day and night. Do not miss any doses. Some of these medicines are most effective when taken with a full glass of water on an empty stomach, but they may be taken with food if stomach upset is a problem. Others work equally well when taken with or without food. Check package directions or ask the physician or pharmacist for instructions on how to take the medicine.

Precautions

Symptoms should begin to improve within a few days of beginning to take this medicine. If they do not, or if they get worse, check with the physician who prescribed the medicine.

Erythromycins may cause mild diarrhea, that usually goes away during treatment. However, severe diarrhea could be a sign of a very serious side effect. Anyone who develops severe diarrhea while taking erythromycin or related drugs should stop taking the medicine and call a physician immediately.

Special conditions

Taking erythromycins may cause problems for people with certain medical conditions or people who are taking certain other medicines. Before taking these drugs, be sure to let the physician know about any of these conditions:

ALLERGIES. Anyone who has had unusual reactions to erythromycins, azithromycin, or clarithromycin in the past should let his or her physician know before taking the drugs again. The physician should also be told about any allergies to foods, dyes, preservatives, or other substances.

PREGNANCY. Some medicines in this group may cause problems in pregnant women and have the potential to cause birth defects. Women who are pregnant or who may become pregnant should check with their physicians before taking these drugs.

BREASTFEEDING. Erythromycins pass into breast milk. Mothers who are breastfeeding and who need to take this medicine should check with their physicians.

OTHER MEDICAL CONDITIONS. Before using erythromycins, people with any of these medical problems should make sure their physicians are aware of their conditions:

  • heart disease
  • liver disease
  • hearing loss

USE OF CERTAIN MEDICINES. Taking erythromycins with certain other drugs may affect the way the drugs work or may increase the chance of side effects.

Side effects

The most common side effects are mild diarrhea, nausea, vomiting, and stomach or abdominal cramps. These problems usually go away as the body adjusts to the drug and do not require medical treatment. Less common side effects, such as sore mouth or tongue and vaginal itching and discharge also may occur and do not need medical attention unless they persist or are bothersome.

More serious side effects are not common, but may occur. If any of the following side effects occur, check with a physician immediately:

  • severe stomach pain, nausea, vomiting, or diarrhea
  • fever
  • skin rash, redness, or itching
  • unusual tiredness or weakness

Although rare, very serious reactions to azithromycin (Zithromax) are possible, including extreme swelling of the lips, face, and neck, and anaphylaxis (a violent allergic reaction). Anyone who develops these symptoms after taking azithromycin should stop taking the medicine and get immediate medical help.

Other rare side effects may occur with erythromycins and related drugs. Anyone who has unusual symptoms after taking these medicines should get in touch with his or her physician.

Interactions

Erythromycins may interact with many other medicines. When this happens, the effects of one or both of the drugs may change or the risk of side effects may be greater. Anyone who takes erythromycins should let the physician know all other medicines he or she is taking. Among the drugs that may interact with erythromycins are:

  • acetaminophen (Tylenol)
  • medicine for overactive thyroid
  • male hormones (androgens)
  • female hormones (estrogens)
  • other antibiotics
  • blood thinners
  • disulfiram (Antabuse), used to treat alcohol abuse
  • antiseizure medicines such as valproic acid (Depakote, Depakene)
  • caffeine
  • the antihistamines astemizole (Hismanal)
  • antiviral drugs such as (zidovudine) Retrovir

KEY TERMS

Bronchitis Inflammation of the air passages of the lungs.

Gonorrhea A sexually transmitted disease (STD) that causes infection in the genital organs and may cause disease in other parts of the body.

Inflammation Pain, redness, swelling, and heat that usually develop in response to injury or illness.

Legionnaire's disease A lung disease caused by a bacterium.

Microorganism An organism that is too small to be seen with the naked eye.

Pelvic inflammatory disease (PID) Inflammation of the female reproductive tract, caused by any of several microorganisms. Symptoms include severe abdominal pain, high fever, and vaginal discharge. Severe cases can result in sterility.

Pneumonia A disease in which the lungs become inflamed. Pneumonia may be caused by bacteria, viruses, or other organisms, or by physical or chemical irritants.

Sinus Any of several air-filled cavities in the bones of the skull.

Strep throat A sore throat caused by infection with Streptococcus bacteria. Symptoms include sore throat, chills, fever, and swollen lymph nodes in the neck.

Tonsillitis Inflammation of a tonsil, a small mass of tissue in the throat.

Urinary tract The passage through which urine flows from the kidneys out of the body.

The list above does not include every drug that may interact with erythromycins. Be sure to check with a physician or pharmacist before combining erythromycins with any other prescription or nonprescription (over-the-counter) medicine.

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"Erythromycins." Gale Encyclopedia of Medicine, 3rd ed.. . Retrieved August 23, 2017 from Encyclopedia.com: http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/erythromycins

erythromycin

erythromycin (ĬrĬth´rōmī´sĬn), any of several related antibiotic drugs produced by bacteria of the genus Streptomyces (see antibiotic). Erythromycin is most effective against gram-positive bacteria such as pneumococci, streptococci, and some staphylococci (see Gram's stain). The antibiotic also has some effect on gram-negative bacteria and some fungi. Erythromycin inhibits protein synthesis in susceptible microorganisms. It is used to treat such diseases as pneumonia caused by fungi, and streptococcus and syphilis infections, especially where the patient is allergic to penicillin.

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"erythromycin." The Columbia Encyclopedia, 6th ed.. . Encyclopedia.com. 23 Aug. 2017 <http://www.encyclopedia.com>.

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"erythromycin." The Columbia Encyclopedia, 6th ed.. . Retrieved August 23, 2017 from Encyclopedia.com: http://www.encyclopedia.com/reference/encyclopedias-almanacs-transcripts-and-maps/erythromycin

erythromycin

erythromycin (i-rith-roh-my-sin) n. an antibiotic used to treat infections caused by a wide range of bacteria and other microorganisms. It is administered by mouth or injection or topically. Trade names: Erymax, Erythrocin, Erythroped, Stiemycin.

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"erythromycin." A Dictionary of Nursing. . Encyclopedia.com. (August 23, 2017). http://www.encyclopedia.com/caregiving/dictionaries-thesauruses-pictures-and-press-releases/erythromycin

"erythromycin." A Dictionary of Nursing. . Retrieved August 23, 2017 from Encyclopedia.com: http://www.encyclopedia.com/caregiving/dictionaries-thesauruses-pictures-and-press-releases/erythromycin