Erythromycin, 250 mg 20 pcs

Bacteriostatic antibiotic of macrolide group, binds reversibly to 50S-subunit of ribosomes in its donor part, which disrupts formation of peptide bonds between amino acid molecules and blocks protein synthesis of microorganisms (does not affect nucleic acid synthesis). When used in high doses it may show bactericidal effect.

The spectrum of action includes Gram-positive (Staphylococcus spp, producing and not producing penicillinase, including Staphylococcus aureus, Streptococcus spp (including Streptococcus pneumoniae, Streptococcus pyogenes), alpha-hemolytic streptococcus (Viridans group), Bacillus anthracis, Corynoebacterium diphtheriae, Corynoebacterium minutissimum) and gram-negative microorganisms (Neisseria gonorrhoeae, Haemophilus influenzae, Bordetella pertussis, Brucella spp, Legionella spp. including Legionella pneumophila) and other microorganisms: Mycoplasma spp. (including Mycoplasma pneumoniae), Chlamydia spp. (including Chlamydia trachomatis), Treponema spp., Rickettsia spp., Entamoeba histolytica, Listeria monocytogenes.

Resistant Gram-negative bacilli: Escherichia coli, Pseudomonas aeruginosa as well as Shigella spp., Salmonella spp. and others.

It is a motilin receptor agonist. It accelerates the evacuation of gastric contents by increasing the amplitude of contraction of the pylorus and improving the antral-duodenal coordination.

Indications

Bacterial infections caused by sensitive microflora: diphtheria (including bacterial carriage), whooping cough (including prevention), brucellosis, Legionnaires’ disease, erythrasma, listeriosis, scarlet fever, amoebic dysentery, gonorrhea; genitourinary infections in pregnant women caused by Chlamydia trachomatis; primary syphilis (in patients with allergies to penicillins); uncomplicated chlamydia in adults (with localization in the lower genitourinary tract and rectum) with intolerance or ineffectiveness of tetracyclines, etc.; infections of the ENT organs (tonsillitis, otitis media, sinusitis); biliary tract infections (cholecystitis); infections of the upper and lower respiratory tract (tracheitis, bronchitis, pneumonia); infections of the skin and soft tissues (pustular skin diseases, including juvenile acne, infected wounds, bedsores, stage II-III burns, trophic ulcers).

Prevention of exacerbations of streptococcal infections (tonsillitis, pharyngitis) in patients with rheumatism. Prevention of infectious complications during medical and diagnostic procedures (including preoperative bowel preparation, dental interventions, endoscopy, in patients with heart defects).

It is a reserve antibiotic for the treatment of bacterial infections caused by strains of gram-positive pathogens (in particular, staphylococci) resistant to penicillin.

Erythromycin is the drug of choice in patients with hypersensitivity to penicillins.

Pharmacological effect

A bacteriostatic antibiotic from the macrolide group, reversibly binds to the 50S ribosomal subunit in its donor part, which disrupts the formation of peptide bonds between amino acid molecules and blocks the synthesis of microbial proteins (does not affect the synthesis of nucleic acids). When used in high doses, it can exhibit a bactericidal effect.

The spectrum of action includes gram-positive (Staphylococcus spp., producing and not producing penicillinase, including Staphylococcus aureus, Streptococcus spp (including Streptococcus pneumoniae, Streptococcus pyogenes), alpha-hemolytic streptococcus (Viridans group), Bacillus anthracis, Corynebacterium diphtheriae, Corynebacterium minutissimum) and gram-negative microorganisms (Neisseria gonorrhoeae, Haemophilus influenzae, Bordetella pertussis, Brucella spp., Legionella spp., including Legionella pneumophila) and other microorganisms: Mycoplasma spp. (including Mycoplasma pneumoniae), Chlamydia spp. (including Chlamydia trachomatis), Treponema spp., Rickettsia spp., Entamoeba histolytica, Listeria monocytogenes.

Resistant gram-negative rods: Escherichia coli, Pseudomonas aeruginosa, as well as Shigella spp., Salmonella spp. and others.

It is a motilin receptor agonist. Accelerates the evacuation of gastric contents by increasing the amplitude of pyloric contraction and improving antral-duodenal coordination.

Special instructions

Symptoms of cholestatic jaundice may develop several days after the start of therapy, but the risk of development increases after 7-14 days of continuous therapy.

The likelihood of developing an ototoxic effect is higher in patients with renal and liver failure, as well as in elderly patients.

Some resistant strains of Haemophilus influenzae are sensitive to simultaneous administration of erythromycin and sulfonamides.

May interfere with the determination of catecholamines in urine and the activity of “liver” transaminases in the blood (colorimetric determination using definylhydrazine).

Newborns receiving erythromycin are at high risk of developing pyloric stenosis. Numerous clinical studies have proven the antral and duodenal prokinetic effect of erythromycin.

During long-term treatment with erythromycin, it is necessary to monitor laboratory parameters of liver function.

Use caution in patients simultaneously treated with drugs whose metabolism occurs with the participation of monooxidases dependent on cytochrome P-450.

Broad-spectrum antibiotics (eg macrolides, semisynthetic penicillins, cephalosporins) can sometimes cause pseudomembranous colitis. Suppression of normal bacterial flora in the intestine promotes the development of Clostridium difficile, the toxins of which cause the clinical symptoms of pseudomembranous colitis. Therefore, patients who experience diarrhea during antibiotic treatment or immediately after its discontinuation should not be treated themselves, but should consult a doctor.

If pseudomembranous colitis is confirmed, erythromycin should be immediately discontinued and appropriate treatment initiated. In mild cases, it is enough to discontinue the drug; in more severe cases, it is necessary to take metronidazole or vancomycin. Taking drugs that inhibit intestinal motility or other anti-laxative agents is contraindicated.

Active ingredient

Erythromycin

Composition

Erythromycin 250 mg.

Excipients:

povidone – 9.45 mg,

crospovidone – 13.5 mg,

calcium stearate – 4.14 mg,

talc – 10.35 mg,

potato starch – up to kernel weight 450 mg.

Shell composition:

cellacephate 16.2 mg, titanium dioxide 0.8 mg, castor oil 3 mg.

Pregnancy

The use of Erythromycin in pregnant and breastfeeding women is not recommended unless the expected benefit outweighs the potential harm.

Due to the possibility of passage into breast milk, breastfeeding should be avoided when erythromycin is prescribed.

Contraindications

hypersensitivity to macrolide antibiotics or to any other substance included in the drug,
simultaneous use of terfenadine or astemizole,
significant hearing loss.

Use with caution in patients with functional liver disorders, arrhythmia (history), prolongation of the QT interval, jaundice (history), liver or kidney failure, during lactation.

Side Effects

From the digestive system: nausea, vomiting, gastralgia, abdominal pain, tenesmus, diarrhea, dysbiosis, rarely – oral candidiasis, pseudomembranous enterocolitis, liver dysfunction, cholestatic jaundice, increased activity of “liver” transaminases, pancreatitis.

Diarrhea that occurs during treatment with erythromycin should be reported to the doctor, because this may be a symptom of pseudomembranous enterocolitis.

During a long-term or repeated course of treatment with erythromycin, a superinfection caused by drug-resistant bacteria or fungi may develop.

On the part of the hearing organs: reversible ototoxicity – hearing loss and/or tinnitus (when using high doses – more than 4 g / day).

From the cardiovascular system: rarely – tachycardia, prolongation of the QT interval on the electrocardiogram, atrial fibrillation and/or flutter (in patients with a prolonged QT interval on the electrocardiogram).

Allergic reactions: urticaria, other forms of skin rash, eosinophilia, rarely – anaphylactic shock.

Other undesirable effects that may occur after taking erythromycin: agranulocytosis, disorders of the nervous system (dizziness, confusion, hallucinations), nightmares.

Interaction

Incompatible with lincomycin, clindamycin and chloramphenicol (antagonism). Reduces the bactericidal effect of beta-lactam antibiotics (penicillins, cephalosporins, carbopenems). Increases theophylline content.

Drugs that block tubular secretion prolong the half-life of erythromycin.

When taken simultaneously with drugs that are metabolized in the liver (carbamazepine, valproic acid, hexobarbital, phenytoin, alfentanil, disopyramide, lovastatin, bromocretin), the concentration of these drugs in plasma may increase (it is an inhibitor of microsomal liver enzymes).

Increases the nephrotoxicity of cyclosporine (especially in patients with concomitant renal failure). Reduces the clearance of triazolam and midazolam, and therefore may enhance the pharmacological effects of benzodiazepines.

When taken simultaneously with terfenadine or astemizole – the possibility of developing arrhythmia (ventricular fibrillation and flutter, ventricular tachycardia, even death), with dihydroergotamine or non-hydrogenated ergot alkaloids – vasoconstriction to spasm, dysesthesia.

Slows down the elimination (increases the effect) of methylprednisolone, felodipine and coumarin anticoagulants.

When administered together with lovastatin, rhabdomyolysis increases.

Increases the bioavailability of digoskin.

Reduces the effectiveness of hormonal contraception.

Overdose

Symptoms: impaired liver function, up to acute liver failure, hearing loss.

Treatment: activated carbon, careful monitoring of the state of the respiratory system (if necessary, artificial ventilation), acid-base status and electrolyte metabolism, electrocardiography. Hemodialysis, peritoneal dialysis, and forced diuresis are ineffective.

Storage conditions

Store at temperatures up to 25°C. Protect from moisture.
Keep out of the reach of children.

Shelf life

3 years.

Manufacturer

ABVA RUS, Russia