How you take a drug can affect how well it works and how safe it will be for you. Sometimes it can be almost as important as what you take. Timing, what you eat and when you eat, proper dose, and many other factors can mean the difference between feeling better, staying the same, or even feeling worse. This drug information page is intended to help you make your treatment work as effectively as possible. It is important to note, however, that this is only a guideline. You should talk to your doctor about how and when to take any prescribed drugs.
The ninth installment in this series of articles on commonly prescribed medications is about erythromycin, an antibiotic used alone or in combination with other chemicals or drugs to treat various infections. Erythromycins also are used as part of a preoperative bowel preparation that suppresses the normal bacterial flora, thus reducing the chances of infection following bowel surgery.
Conditions These Drugs Treat
Erythromycin was first isolated in 1952. Like other antibiotics, it is produced by a microorganism-in this case, Streptomyces erythraeus-and has the capacity to inhibit the growth of or to kill other microorganisms. It is effective against a number of common bacteria, including Chlamydia trachomatis, Corynebacterium diphtheriae, Neisseria gonorrhoeae, Listeria monocytogenes, Streptococcus pneumoniae, Bordetella pertussis, Legionella pneumophilia, and Mycoplasma pneumoniae.
It is used to treat conditions caused by those organisms, such as diphtheria, gonorrhea, Legionnaires' disease, pneumonia, sinusitis caused by S. pneumoniae, pertussis (whooping cough), rheumatic fever, and chlamydial infections of the eyes and genitourinary tract and, in infants, lungs. It also is used for penicillin-allergic patients who have syphilis.
The skin preparations are prescribed for acne.
Erythromycin will not cure or combat colds, flu, or other viral infections.
How to Take
Erythromycin may be applied to the eyes (eye ointment) or to the skin (topical gels, ointments, swabs or liquids), swallowed (liquid, tablet or capsule), or administered intravenously fluid).
The doctor determines the dosage, including the dose and treatment period, depending on the type and severity of the infection.
The medication should be taken for the full time prescribed, even if symptoms are no longer present, to ensure that the infection does not recur. The exception might be if side effects occur, in which case the doctor should be consulted. For patients with "strep" infection, it is important that the medicine be taken for at least 10 days, or as prescribed by the doctor. Serious heart problems, such as rheumatic fever, could develop later if the infection isn't cleared up completely.
In general, the eye ointment is applied at least twice daily, the skin preparations twice daily (in the morning and at night), and erythromycin taken by mouth is taken daily at 6- or 12-hour intervals. Intravenous erythromycin is given continuously. mycin
Most oral forms of erythromycin are absorbed best on an empty stomach and therefore should be taken at least one-half hour before or two hours after a meal. They may be taken with food, however, if they upset the stomach.
Of special note: Chewable tablets, such as Ilosone and EryPed chewable tablets, must be chewed or crushed before they are swallowed.
Delayed-release capsules or tablets, such as Ery-Tab and E-Base delayed-release tablets, should be swallowed whole; they should not be broken or crushed.
Specially marked spoons or other measuring devices that come with liquid oral forms should be used to ensure accurate doses. Household teaspoons should not be used because they may not hold the right amount of liquid.
Erythromycin taken by mouth works best if it circulates in the blood at a constant level. Therefore, it is important that doses not be missed and that they be taken at regular intervals.
If a dose is missed and just a short time has passed, it should be taken as soon as possible. However, if it is time for the next dose, a physician should be consulted before making up the dose.
Relief of Symptoms
Erythromycin usually clears infections within days. However, because it does not relieve symptoms immediately, the doctor may prescribe other medicines, such as aspirin or acetaminophen, to ease pain and fever until the erythromycin takes effect.
Side Effects and Risks
Erythromycin taken by mouth may cause mild stomach cramps, diarrhea, nausea and vomiting, and sore mouth or tongue. These problems are usually minor and may go away as the body adjusts to the medicine. If they persist, however, the doctor should be consulted.
Although relatively rare, other side effects that may occur are:
* with eye ointment: eye irritation not present before therapy
* with skin preparations: dry or scaly skin; itching, stinging, peeling, or redness of the skin
* with medications taken by mouth: skin rash, hives, or itching; dark or amber urine; pale stools; severe stomach pain; unusual tiredness or weakness; or yellow eyes or skin (jaundice)
With intravenous administration: pain, swelling or redness at the injection site.
The doctor should be consulted if any of these side effects occurs.
Precautions and Warnings
Because various adverse drug interactions between erythromycin and other medications can occur, patients should inform their doctors of all prescription and nonprescription drugs they are taking before starting this medicine.
Patients also should tell their doctors:
* if they have ever had an unusual reaction to erythromycin
* if they are pregnant or could possibly become pregnant. Although erythromycin has not been shown to cause birth defects or other problems in humans, it does cross the placenta.
* if they are breast-feeding. Because erythromycin passes into breast milk, a nursing mother should consult her doctor before taking the drug.
* if they are on a low-sodium, low-sugar, or other special diet, or if they are allergic to any foods, sulfites, or other preservatives or dyes that also may be present in an erythromycin-based drug.
* if they have ever had liver disease or hearing loss. Although very rare, patients with kidney problems who take erythromycin may suffer hearing loss, which is reversible after the drug is stopped.
COPYRIGHT 1991 U.S. Government Printing Office
COPYRIGHT 2004 Gale Group