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Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Erythromycin is a broad-spectrum antibiotic drug produced by a strain of Saccharopolyspora erythraea (formerly Streptomyces erythraeus) and belongs to the macrolide group of antibiotics. Erythromycin may be bacteriostatic or bactericidal in action, depending on the concentration of the drug at the site of infection and the susceptibility of the organism involved. Erythromycin is widely used for treating a variety of infections caused by gram-positive bacteria, gram-negative bacteria and many other organisms of the respiratory tract, skin, gastrointestinal and genital tracts including sexually transmitted diseases (syphilis, gonorrhea, Chlamydia infections). In pharmaceutical products, mostly erythromycin base is used, but many other forms (salts and esters) are possible (1).
Infection and immunology
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
Newborn infants do not have transplacentally acquired immunity against pertussis and should be immunized as early as possible. Correct age is 2 months for both full-term and premature infants. Erythromycin has been shown to inhibit the growth of the organism in vitro. The incidence of permanent neurological complications is less than 1 in 150000 cases.
Infections
Published in Anne Lee, Sally Inch, David Finnigan, Therapeutics in Pregnancy and Lactation, 2019
Breastfeeding can continue with the use of amoxycillin, erythromycin or a cephalosporin. Penicillins can theoretically cause sensitisation; therefore breastfeeding mothers should be advised to watch out for rashes or other signs of allergy in their infant. Tetracyclines are advised against, although they are probably safe to use as calcium inhibits absorption of the small amounts of tetracycline that pass into breast milk.46,47
Neonatal ocular prophylaxis in the United States: is it still necessary?
Published in Expert Review of Anti-infective Therapy, 2023
Susannah Franco, Margaret R. Hammerschlag
The incidence of neonatal gonococcal ophthalmia is related to the prevalence of gonococcal infection in women of child bearing age. Treatment of sexually active women and their sex partners has been recommended since the 1970s, when the first CDC treatment recommendations for gonorrhea were published in 1972, 1974, and 1979 [51]. The recommendations specifically state that ‘all pregnant women should have endocervical cultures examined for gonococci as an integral part of prenatal care’. The treatment regimen recommended at that time was a single dose of aqueous procaine penicillin administered intramuscularly plus oral probenecid for uncomplicated gonorrhea in men and women, including pregnant women [52]. Erythromycin was only recommended for use in pregnant women who were allergic to penicillin; IM cefazolin and spectinomycin were recommended as alternatives. Due to increasing resistance, penicillin and tetracycline were no longer recommended for treatment of gonorrhea by 1989. Single-dose IM ceftriaxone became the treatment of choice for uncomplicated gonorrhea in adolescents and adults, including pregnant women, in 1989 [53].
Systematic review and meta-analysis of the safety of erythromycin compared to clarithromycin in adults and adolescents with pneumonia
Published in Journal of Chemotherapy, 2020
Khalid Eljaaly, Ahmed Botaish, Fawaz Bahobail, Mohamed Almehmadi, Ziyad Assabban, Abrar K. Thabit, Basem Alraddadi, Ahmed Aljabri, Nasser Alqahtani, Mohammed A. Aseeri, Almoutaz Hashim, Antoni Torres
The search process identified 548 articles, and a total of five RCTs were included after screening by title and/or abstract and then by full-text (Figure 1).16–18,21,22 The total number of patients included in this meta-analysis was 693 patients. The characteristics of included studies are summarized in Table 1, and the quality assessment of these studies is provided in Table 2. Three RCTs were double-blind18,21,22 and two were open-label.16,17 One RCT was funded by the drug company manufacturing both macrolides,22 while funding source was not reported for the other four RCTs.16–18,21 The studies were conducted in different countries across three continents. The mean age of patients ranged from 22 to 54 years. All studies included adults but one also included some adolescents.22 The duration of therapy ranged from 7 to 14 days with doses ranging from 250 to 500 mg (q6h for erythromycin and q12h for clarithromycin).
Current and future treatment management strategies for gastroparesis
Published in Expert Opinion on Orphan Drugs, 2019
Priyadarshini Loganathan, Mahesh Gajendran, Richard McCallum
Erythromycin induces gastric motility by promoting antral contraction and pyloric relaxation through motilin receptor agonism [29–31]. As per current recommendation, intravenous erythromycin is recommended for inpatient and oral erythromycin in outpatients with GP. Also, high dose (2–3 mg/kg iv every 6–8 h) of intravenous erythromycin could be used to facilitate placement of gastric feeding tubes and decrease tube-feeding residuals. Intravenous 6-mg/kg dose and 500 mg TID dose of oral erythromycin prior to meals have been studied. Gastric retention at 2 h was 85% at baseline vs. 20% following intravenous erythromycin (p < 0.001) and 4 weeks of oral therapy sustained same improvement to 48% remaining (p < 0.01) [31]. Intravenous erythromycin is subjected to limited availability due to possible cardiac effects. It has been recommended to have intermittent ‘drug holidays,’ as tachyphylaxis may develop with reduced effectiveness [28,32]. However, a randomized trial of the motilin receptor agonist (ABT-229) vs. placebo failed to show improvement in clinical symptoms in patients with T1DM with or without delayed GE and thus the pipeline for developing new motilin agonists is being reassessed [33].