To date, one of the most effective groups of antibiotics are macrolides, the most prominent of which is Erythromycin. This drug has a wide range of antimicrobial effects and shows a high level of therapeutic activity in the treatment of a large number of pathologies of bacterial origin. Due to the fact that improper use of this antibiotic can adversely affect the state of healthy intestinal microflora, it is necessary to take Erythromycin only according to the instructions of the attending physician.
Mechanism of action
Erythromycin (active component) belongs to the macrolide group of antibiotics. In a bacterial cell, the compound disrupts protein compounds' synthesis by binding to the 50S ribosome subunit. The drug has a bacteriostatic effect, which is characterized by stopping the growth and reproduction of bacterial microorganisms sensitive to Erythromycin. The drug has sufficient activity against many gram-positive and gram-negative bacteria, including staphylococci, streptococci, Legionella, corynebacteria diphtheria, pneumococci, Listeria, Mycoplasma, chlamydia, Bordetella (pathogens of whooping cough and paracoclussis), some strains of Pseudomonas aeruginosa. Erythromycin has almost no effect on E. coli, Salmonella, Shigella.
After taking the pill Erythromycin, the active compound is absorbed into the blood. Depending on certain characteristics (the digestive system's functional state, taking the drug after a meal or on an empty stomach), bioavailability can vary from 35 to 65%. After absorption into the blood, Erythromycin is evenly distributed in the tissues. It enters the brain tissue through the brain barrier and enters the body of the developing fetus through the placenta. During lactation, Erythromycin is detected in breast milk. The substance's metabolism takes place in the liver, and active and inactive decomposition products are almost completely excreted with bile into the intestinal lumen.
Indications for the use of Erythromycin
According to the instructions, treatment with Erythromycin is indicated for various infectious and inflammatory processes, including respiratory tract infections, diphtheria, prostatitis, scarlet fever, amoebic dysentery, listeriosis, syphilis, cholecystitis, gonorrhea. Erythromycin is used in the treatment of soft tissue and skin infections - trophic ulcers, second-and third-degree burns, furunculosis, infected wounds, and pustular skin diseases. The antibiotic is also used for various infections of the eye mucosa (including conjunctivitis in newborns), for urogenital infections in pregnant women caused by Chlamydia trachomatis. Reviews of Erythromycin indicate that this antibiotic is often used to prevent infectious complications in various diagnostic and therapeutic procedures.
The drug is also used to prevent the corresponding infectious processes. Erythromycin is a second-line antibiotic that is prescribed to patients who are allergic to penicillins.
Method of use and dosage
The pills are taken orally as a whole. They are washed down with a sufficient amount of liquid for better passage through the esophagus. The dosage of the drug Erythromycin depends on the patient's age:
- Adults and adolescents over 12 years of age take 250 mg, which are taken in 4-6 hours, while the total daily dosage should not exceed 4 g. If there is a severe infectious disease, a single dosage is increased to 500 mg.
- Children older than 4 months should take the dose calculated depending on the severity of the infectious process based on the indicator of 30-50 mg per 1 kg of body weight per day.
- Children under 4 months of age take the daily therapeutic dose calculated based on the indicator of 20-40 mg per 1 kg of body weight of the child.
- The average frequency of taking pills for all age groups of patients is 4 times a day. The duration of treatment depends on the severity of the infectious pathology, it varies from 5 days to 2 weeks. After the disappearance of clinical manifestations of infection, the pills are taken for another 2 days.
- Side effects in the treatment of Erythromycin occur infrequently. Reviews of Erythromycin say that prolonged use of the antibiotic causes vomiting, diarrhea, nausea, and jaundice. Judging by the reviews, Erythromycin in some cases, can cause allergic reactions. Long-term use of Erythromycin contributes to the development of resistance to it of pathogenic microorganisms.
Before prescribing the Erythromycin, the attending physician must carefully read the annotation. It specifies the following features of proper use of the drug:
Before prescribing the drug, make sure that there are appropriate medical indications, and also exclude contraindications.
If you want to obtain a good therapeutic effect, it is recommended to prescribe a laboratory bacteriological study to determine the type of pathogen.
The drug should be taken in accordance with the principles of rational antibiotic therapy – the antibiotic should be prescribed in the appropriate dosage to prevent the development of resistance in bacteria, and it is important to correctly observe the duration and mode of use of the drug.
In the background of drug therapy, laboratory monitoring of the liver and kidneys' functional state is prescribed.
Patients with concomitant renal impairment and the elderly have an increased risk of hearing impairment, as well as changes in the rhythm and frequency of heart contractions.
During the treatment of syphilis in pregnant women, Erythromycin's concentration in the developing fetus is significantly lower. This requires additional etiotropic therapy of the child after birth.
If a patient has concomitant myasthenia gravis, the course of the disease may worsen after starting taking Erythromycin.
It is not recommended to take the Erythromycin with milk, as this reduces the bioavailability of the active substance.
During pregnancy, the drug is prescribed only for the strict medical reasons.
The drug may interact with drugs of other groups (clindamycin, lincomycin, chloramphenicol, terfenadine, astemizole, theophylline, penicillins, carbamazepine, phenobarbital, disopyramide, lovastatin), so their possible use should be warned by the attending physician.
When taking pills Erythromycin, potentially dangerous activities, such as driving, should be performed with caution.