ERYTHROMYCIN
Drugs in Pregnancy and Lactation.
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Name: ERYTHROMYCIN
Class: Antibiotic
Risk Factor: BM
Fetal Risk Summary
No reports linking the use of erythromycin with congenital defects have been located. The drug was not teratogenic in female rats fed erythromycin (up to 0.25% of the diet) before and during mating, and throughout gestation and weaning (1).
Erythromycin crosses the placenta but in concentrations too low to treat most pathogens (2,3 and 4). Fetal tissue levels increase after multiple doses (4). However, a case has been described in which erythromycin was used successfully to treat maternal syphilis but failed to treat the fetus adequately (5). During pregnancy, erythromycin serum concentrations vary greatly as compared to those in normal men and nonpregnant women, which might account for the low levels observed in the fetus (6).
The estolate salt of erythromycin has been observed to induce hepatotoxicity in pregnant patients (7). Approximately 10% of 161 women treated with the estolate form in the 2nd trimester had abnormally elevated levels of serum glutamic-oxaloacetic transaminase, which returned to normal after therapy was discontinued.
The use of erythromycin in the 1st trimester was reported in a mother who delivered an infant with left absence-of-tibia syndrome (8). The mother was also exposed to other drugs, which makes a relationship to the antibiotic unlikely.
The Collaborative Perinatal Project monitored 50,282 mother-child pairs, 79 of whom had 1st trimester exposure to erythromycin (9, pp. 297313). For use anytime during pregnancy, 230 exposures were recorded (9, p. 435). No evidence was found to suggest a relationship to large categories of major and minor malformations or to individual defects. Erythromycin, like many other antibiotics, lowers urine estriol concentrations (see also Ampicillin for mechanism and significance) (10). The antibiotic has been used during the 3rd trimester to reduce maternal and infant colonization with group B b-hemolytic streptococcus (11,12). Erythromycin has also been used during pregnancy for the treatment of genital mycoplasmas (13, 14). A reduction in the rates of pregnancy loss and low-birth-weight infants was seen in patients with mycoplasma infection after treatment with erythromycin.
In a surveillance study of Michigan Medicaid recipients involving 229,101 completed pregnancies conducted between 1985 and 1992, 6,972 newborns had been exposed to erythromycin during the 1st trimester (F. Rosa, personal communication, FDA, 1993). A total of 320 (4.6%) major birth defects were observed (297 expected). Specific data were available for six defect categories, including (observed/expected) 77/70 cardiovascular defects, 14/11 oral clefts, 1/3 spina bifida, 22/20 polydactyly, 14/12 limb reduction defects, and 11/17 hypospadias. These data do not support an association between the drug and congenital malformations.
Breast Feeding Summary
Erythromycin is excreted into breast milk (15). Following oral doses of 400 mg every 8 hours, milk levels ranged from 0.4 to 1.6 ΅g/mL. Oral doses of 2 g/day produced milk concentrations of 1.63.2 ΅g/mL. The milk:plasma ratio in both groups was 0.5. No reports of adverse effects in infants exposed to erythromycin in breast milk have been located. However, three potential problems exist for the nursing infant: modification of bowel flora, direct effects on the infant, and interference with the interpretation of culture results if a fever workup is required. The American Academy of Pediatrics considers the antibiotic to be compatible with breast feeding (16).
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References
- Product information. Ery-Tab. Abbott Laboratories, 2000.
- Heilman FR, Herrell WE, Wellman WE, Geraci JE. Some laboratory and clinical observations on a new antibiotic, erythromycin (Ilotycin). Proc Staff Meet Mayo Clin 1952;27:285304.
- Kiefer L, Rubin A, McCoy JB, Foltz EL. The placental transfer of erythromycin. Am J Obstet Gynecol 1955;69:1747.
- Philipson A, Sabath LD, Charles D. Transplacental passage of erythromycin and clindamycin. N Engl J Med 1973;288:121920.
- Fenton LJ, Light LJ. Congenital syphilis after maternal treatment with erythromycin. Obstet Gynecol 1976;47:4924.
- Philipson A, Sabath LD, Charles D. Erythromycin and clindamycin absorption and elimination in pregnant women. Clin Pharmacoal Ther 1976;19:6877.
- McCormack WM, George H, Donner A, Kodgis LF, Albert S, Lowe EW, Kass EH. Hepatotoxicity of erythromycin estolate during pregnancy. Antimicrob Agents Chemother 1977;12:6305.
- Jaffe P, Liberman MM, McFadyen I, Valman HB. Incidence of congenital limb-reduction deformities. Lancet 1975;1:5267.
- Heinonen OP, Slone D, Shapiro S. Birth Defects and Drugs in Pregnancy. Littleton, MA:Publishing Sciences Group, 1977.
- Gallagher JC, Ismail MA, Aladjem S. Reduced urinary estriol levels with erythromycin therapy. Obstet Gynecol 1980;56:3812.
- Merenstein GB, Todd WA, Brown G, Yost CC, Luzier T. Group B B-hemolytic streptococcus: randomized controlled treatment study at term. Obstet Gynecol 1980;55:3158.
- Easmon CSF, Hastings MJG, Deeley J, Bloxham B, Rivers RPA, Marwood R. The effect of intrapartum chemoprophylaxis on the vertical transmission of group B streptococci. Br J Obstet Gynaecol 1983;90:6335.
- Quinn PA, Shewchuk AB, Shuber J, Lie KI, Ryan E, Chipman ML, Nocilla DM. Efficacy of antibiotic therapy in preventing spontaneous pregnancy loss among couples colonized with genital mycoplasmas. Am J Obstet Gynecol 1983;145:23944.
- Kass EH, McCormack WM. Genital mycoplasma infection and perinatal morbidity. N Engl J Med 1984;311:258.
- Knowles JA. Drugs in milk. Pediatr Currents 1972;21:2832.
- Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:13750.
Q&A about Erythromycin
How long does Erythromycin take to work?
I have a sinus infection caused by the root canal I had done on a upper molar. Its day 3 of taking the tablet and still in pain. How long should it take?
Something that you should be aware of that there are more and more bugs that are getting more resistant to antibiotics as they mutate. Super bugs like MRSA are very hard to kill off now because of their ability to adapt and resist the antibiotics so developed.
Ask your dental surgeon which pain killer he/she would recommend to assist you with pain relief.
Can i get erythromycin without a prescription
cuz
i dont have much acne =]
lol
i might just be overdoing it..
but still\
lol
i used my friends erythromycin pads
and it did wonder for my skin in days..
like
i got like a celebrity face =]
lmao
and id like to keep it that way so i was wonderin can i get it anywhere without prescription or somthing similar?
You can't get it legally without a prescription in the U.S., and I doubt you'll find it on the black market.
There is a product that cleared up my daughter's face in 10 days and she has gorgeous skin now. It's called Zapzyt and I bought it at http://www.drugstore.com. It's on sale right now for $11.99 for the three-step pack, which is what I bought for her. She had previously tried Proactiv, which didn't work for her and was a lot more expensive.
Good luck, acne sux.
is it ok for acne?
TOPICAL DRUGS. Treatment for mild noninflammatory acne consists of reducing the formation of new comedones with topical tretinoin, benzoyl peroxide, adapalene, or salicylic acid. Tretinoin is especially effective because it increases turnover (death and replacement) of skin cells. When complicated by inflammation, topical antibiotics may be added to the treatment regimen. Improvement is usually seen in two to four weeks.
Topical medications are available as cream, gel, lotion, or pad preparations of varying strengths. They include antibiotics (agents that kill bacteria), such as erythromycin, clindamycin (Cleocin-T), and meclocycline (Meclan); comedolytics (agents that loosen hard plugs and open pores) such as the vitamin A acid tretinoin (Retin-A), salicylic acid, adapalene (Differin), resorcinol, and sulfur. Drugs that act as both comedolytics and antibiotics, such as benzoyl peroxide, azelaic acid (Azelex), or benzoyl peroxide plus erythromycin (Benza-mycin),
Or if the acne problem is more you can consult a Skin Doctor.
Erythromycin the antibiotic. Not delayed released capsule. Just a pill.
My father says I have an allergic reaction to erythromycin. Is amoxicilin or penicilin still safe for me to take?
Thanks!
If you are concerned, mention this to your doctor and also ask your pharmacist. Read the information that comes with the meds and ask questions on anything that is not clear.
Be advised that not all reactions happen within minute of taking the medication; some can occur later (6-8 hours later). Watch for symptoms, since you have already had a reaction they caould be similar. Your informational packet will also describe what the most common symptoms are. If you feel weird, call the doctor or pharmacy. They will be able to help answer questions.
Any severe reaction symptoms like face swelling or slurring of speech call 911 and get to the ER.
I've been keeping it at room temperature for the last 3 or 4 days before I realized it said in fine print to put in the refrigerator. Is the medicine still good? I never had to put my erythromycin topical liquid in the fridge.
My dentist has just prescribed me 250mg of erythromycin for a tooth that is infected because it needs a root canal. The pain is pretty intense, and I can't keep taking painkillers because I'm pregnant and I'm afraid it might harm my baby. It's a course of 4 tablets a day for 5 days.
When do you think I should start feeling pain relief from the medicen fighting the infection? Also are there any side effects with this medicen?
Thanks xxx
I have a lower left side pain in my back and I have researched the web to see what I may have. I think it is a bladder infection. Should I take the erythromycin for the infection?
It's really a bad idea to diagnose yourself. Even doctors/PAs/NPs are discouraged from doing this. And they know a lot more than the average lay person.
It's likely that e-mycin is NOT the right drug, even if you do have a UTI. Taking it could prolong the infection, increase complications, and help produce more drug resistant bacteria.
Hi there what is the difference between Erythromycin and Erythrocin antibiotics?.
Are the ingredients different or is it just a case of different brand names etc?
Essentially if someone isnt allergic to Erthromycin should they be fine with Erythocin as the active ingredient is the same/similar?
