KEY POINTS
- Erythromycin is a macrolide antibiotic that interferes with the growth of susceptible bacteria by inhibiting RNA-dependent protein synthesis at the chain elongation step
- Binds to the 50S ribosomal subunit, which blocks transpeptidation
- Available oral, injectable, topical and ophthalmic
- Has activity versus a variety of bacteria, but is not commonly used today
- Clarithromycin has less GI effects than erythromycin
- Azithromycin has less GI side effects and less drug-interactions than erythromycin or clarithromycin
- Is a motilin-agonist and is used off-label for gastroparesis
- The different products have different absorption
- 400mg ethylsuccinate gives the same serum levels as 250mg base or erythromycin stearate
- Ophthalmic erythromycin is used for prophylaxis versus Neisseria gonorrhoeae and Chlamydia trachomatis
RESOURCES
- Erythromycin Ethylsuccinate Oral Package Insert
- Erythromycin Oral Solution Package Insert
- Erythromycin Delayed-Release Capsule Package Insert
- Erythromycin Lactobionate Intravenous Package Insert
- IDSA Guidelines
- CDC Sexually Transmitted Diseases Guidelines
- Mayo Clinic Macrolide Review (1999)
- Macrolide Review (2011)