Erythromycin lyophilizate, bottle 100mg

Composition

Erythromycin phosphate ( in terms of erythromycin) – 100 mg

Pharmacological action

A bacteriostatic antibiotic from the macrolide group, reversibly binds to the 50S subunit of ribosomes, 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, depending on the type of pathogen, it can show a bactericidal effect.

Sensitive microorganisms include those whose growth is delayed at an antibiotic concentration of less than 0.5 mg/l, moderately sensitive – 1-6 mg/l, and resistant – 6-8 mg/l.

The spectrum of action includes: gram-positive microorganisms: Staphylococcus spp., producing and not producing penicillinase, including Staphylococcus aureus; Streptococcus spp. Streptococcus pneumoniae, Streptococcus pyogenes), alpha-hemolytic streptococcus (Viridans group), Bacillus anthracis, Corynebacterium diphtheriae, Corynebacterium minutissimum; gram-negative microorganisms: Neisseria gonorrhoeae, Haemophilus influenzae, Campylobacter jejuni, 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. Gram-negative bacilli are resistant to the drug: Escherichia coli, Pseudomonas aeruginosa, as well as Shigella spp., Salmonella spp., Bacteroides fragilis, Enterobacter spp., etc.

Indications

Severe forms of bacterial infections caused by sensitive pathogens: diphtheria (including bacterial carriers), whooping cough, trachoma, brucellosis, legionnaires ‘ disease, erythrasma, listeriosis, scarlet fever, amoebic dysentery, gonorrhea; genitourinary infections in pregnant women caused by Chlamydia trachomatis; primary syphilis (in patients with penicillin allergy); ENT infections (tonsillitis, otitis media sinusitis); biliary tract infections (cholecystitis); upper and lower respiratory tract infections (tracheitis, bronchitis, pneumonia); skin and soft tissue infections (infected wounds, pressure sores, burns of the II-III degree, trophic ulcers).

Prevention of infectious complications in medical and diagnostic procedures (including preoperative bowel preparation, dental interventions, endoscopy) in patients with heart defects.

Gastroparesis (including gastroparesis after vagotomy, diabetic gastroparesis, and gastroparesis associated with progressive systemic sclerosis).

Contraindications

Hypersensitivity, significant hearing loss, concomitant use of terfenadine or astemizole, lactation.

With caution:

arrhythmias (in the anamnesis), prolongation of the QT interval, jaundice (in the anamnesis), hepatic and / or renal failure, pregnancy.

Use during pregnancy and lactation

The use of the drug during pregnancy is possible if the intended benefit to the mother exceeds the potential risk to the fetus.

If it is necessary to use the drug during lactation, the question of stopping breastfeeding should be decided.

Side effects

From the gastrointestinal tract: nausea, vomiting, gastralgia, abdominal pain, tenesmus, diarrhea, dysbiosis, rarely-oral candidiasis, pseudomembranous enterocolitis, impaired liver function, cholestatic jaundice, increased activity of “liver” transaminases, pancreatitis. Newborns receiving erythromycin have a high risk of developing pylorostenosis.

From the side of the hearing organs: ototoxicity – hearing loss and / or tinnitus (when used in high doses-more than 4 g / day, usually reversible).

From the cardiovascular system: rarely-tachycardia, prolongation of the QT interval on the ECG, atrial fibrillation and/or flutter (in patients with an extended QT interval on the ECG).

Allergic reactions: urticaria, skin rash, eosinophilia, rarely-anaphylactic shock.

Local reactions: phlebitis at the site of intravenous use.

Interaction

Reduces the bactericidal effect of beta-lactam antibiotics (penicillins, cephalosporins, carbopenems). Increases the concentration of theophylline. Intravenous use of erythromycin enhances the effect of ethanol (accelerating gastric emptying and reducing the duration of action of ethanol dehydrogenase in the gastric mucosa). Increases the nephrotoxicity of cyclosporine (especially in patients with concomitant renal insufficiency).

Reduces the clearance of triazolam and midazolam, and therefore may enhance the pharmacological effects of benzodiazepines. Slows down the elimination (enhances the effect) of methylprednisolone, felodipine and coumarin anticoagulants. When co-administered with lovastatin, rhabdomyolysis increases. Increases the bioavailability of digoxin.

Reduces the effectiveness of hormonal contraception. Drugs that block tubular secretion extend the half-life of erythromycin. When taken concomitantly with drugs that are metabolized in the liver (carbamazepine, valproic acid, hexobarbital, phenytoin, alfentanyl, disopyramide, lovastatin, bromocriptine), the concentration of these drugs in plasma may increase (it is an inhibitor of microsomal liver enzymes).

When taken concomitantly with terfenadine or astemizole, arrhythmia may develop (flickering and fluttering of the ventricles, ventricular tachycardia, up to a fatal outcome), with dihydroergotamine or non – hydrogenated ergot alkaloids-vasoconstriction to spasm, dysesthesia. Incompatible with lincomycin, clindamycin and chloramphenicol (antagonism).

How to take, course of use and dosage

 Intravenous slowly (for 3-5 minutes) or drip. Intravenous drip use of the drug is preferable and safer. A single dose of the drug for adults is 0.2 g, daily – 0.6 g.

In severe cases of infection, the daily dose can be increased to 1 g, then the drug is administered 4 times a day (every 6 hours). Children from 4 months to 18 years, depending on age, body weight and severity of infection-30-50 mc/kg/day (for 2-4 injections); children of the first 3 months of life-20-40 mc/kg/day. In case of severe infections, the dose may be doubled.

For intravenous jet use, the drug is dissolved in water for injection or 0.9% sodium chloride solution at the rate of 5 mg per 1 ml of solvent. For intravenous drip use, it is dissolved in 0.9% sodium chloride solution or 5% dextrose solution to a concentration of 1 mg / ml and administered at a rate of 60-80 drops/min.

Intravenously administered for 5-6 days (until a clear therapeutic effect occurs), followed by switching to oral use. With good tolerability and the absence of phlebitis and periflebitis, the course of intravenous use can be extended to 2 weeks (no more). In case of renal insufficiency, there is no need to adjust the dose of the drug.

Overdose

Symptoms: nausea, diarrhea, stomach discomfort; dizziness (especially in patients with hepatic or renal insufficiency); impaired liver function, up to acute liver failure, rarely-hearing impairment.

Treatment: careful monitoring of the state of the respiratory system (if necessary – performing artificial ventilation of the lungs), acid-base state and electrolyte metabolism, ECG. It is necessary to conduct symptomatic therapy. Hemodialysis, peritoneal dialysis, and forced diuresis are ineffective.

Special instructions

With long-term therapy, it is necessary to monitor laboratory parameters of liver function.

Symptoms of cholestatic jaundice may develop a few days after starting therapy, but the risk increases after 7-14 days of continuous therapy.

The probability of developing an ototoxic effect is higher in patients with renal and/or hepatic insufficiency, as well as in elderly patients.

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

It may interfere with the determination of catecholamines in the urine and the activity of “hepatic” transaminases in the blood (colorimetric determination using diphenylhydrazine).

Form of production

Lyophilizate for the preparation of a solution for intravenous use.

Storage conditions

Store in a dry place, protected from light, at a temperature of 15-25 °C

Shelf life

4 years

Active ingredient

Erythromycin

Conditions of release from pharmacies

By prescription

Dosage form

solution for infusions

Purpose

Children as prescribed by a doctor, Adults as prescribed by a doctor

Indications

Pneumonia, Bronchitis, Sore Throat, Eye Infections, Infectious Diseases, Acne, Purulent wounds, Sinusitis, Urinary Tract Infections, Sinusitis, Biliary Tract Infections, Whooping Cough, Pyoderma