Erythromycin

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Erythromycin is a macrolide antibiotic. It is sometimes sold under the brand names ERY-C, Ery-Tab, Erythromycin Base Filmtab, and PCE® Dispertab.[1]

Why It's Prescribed

Erythromycin is prescribed to treat bacterial infections, including bronchitis, diphtheria, Legionnaires' disease, pertussis (whooping cough), pneumonia, rheumatic fever, ear infections, urinary tract infections, some sexually transmitted diseases, and more.[2]

Labeled uses for erythromycin include:[3] Acute Bacterial Sinusitis, Acute Otitis Media Infection, Acute Streptococcal Pyogenes Bacterial Sinusitis, Acute Streptococcus Pneumoniae Bacterial Sinusitis, Bacterial Pneumonia, Chlamydia Cervicitis, Chlamydial Conjunctivitis, Chlamydial Pneumonia, Chlamydia Trachomatis Urethritis, Diphtheria, Diphtheria Prevention, Erythrasma, Legionnaires' Disease, Listeriosis, Mycoplasmal Pneumonia, Neonatal Pneumonia, Nongonococcal Urethritis, Pertussis, Pharyngitis due to Streptococcus Pyogenes, Pneumococcal Acute Otitis Media, Pneumococcal Pharyngitis, Pneumococcal Pneumonia, Preoperative Bowel Preparation, Prevention of Bacterial Endocarditis, Rectal Chlamydia Trachomatis Infection, Recurrent Persistent Urethritis, Rheumatic Fever Prevention, Skin and Skin Structure Infection, Skin and Skin Structure Streptoccous Pyogenes Infection, Staphylococcus Aureus Skin and Skin Structure Infection, Streptococcus Acute Otitis Media, Syphilis

Additionally, it is sometimes used for the following unlabeled uses:[4] Acne Vulgaris, Actinomycosis, Anthrax, Chancroid, Cutaneous Anthrax, Ecthyma, Enteric Campylobacteriosis, Erysipelas, Erysipeloid, Gastroesophageal Reflux, Gastrointestinal Anthrax, Gastroparesis, Granuloma Inguinale, Inhaled Anthrax, Listeria Monocytogenes Septicemia, Lyme Disease, Lymphogranuloma Venereum, Relapsing Fever, Ureaplasma Pneumonia

Form, Route, and Dosage

Erythromycin is available as a capsule, tablet, long-acting capsule, long-acting tablet, chewable tablet, liquid, and pediatric drops to take orally.[5] Erythromycin is available in the strengths 250mg and 500mg.[6] Adults are generally not instructed to take more than 4000mg in a 24 hour period.

Risks

Side Effects

Sometimes patients taking Erythromycin experience side effects. These may include:[7]

  • upset stomach
  • diarrhea
  • vomiting
  • stomach cramps
  • mild skin rash
  • stomach pain
  • severe skin rash
  • itching
  • hives
  • difficulty breathing or swallowing
  • wheezing
  • yellowing of the skin or eyes
  • dark urine
  • pale stools
  • unusual tiredness
  • vaginal infection

As a Pollutant

Because humans and animals often do not fully metabolize pharmaceuticals in their body, they can excrete drugs or their breakdown products, which may the enter the environment.[8]

In Sewage Sludge

Erythromycin has been found in sewage sludge. In the Targeted National Sewage Sludge Survey, a 2009 test of 84 samples of sewage sludge from around the U.S., the EPA found erythromycin in 77 samples (92%) in concentrations ranging from 3.1 to 180 parts per billion.[9] There are no federal regulations governing how much of this drug may be present in sewage sludge applied to land as fertilizer.

Breakdown In the Environment

A 2004 study looked at the ability of 18 antibiotics to biodegrade in a closed bottle test.[10] The antibiotics tested were: Amoxicillin, Benzylpenicillin sodium salt, Ceftriaxone disodium, Cefuroxime sodium salt, Chlortetracycline hydrochloride, Clarithromycin, Clindamycin, Erythromycin, Gentamicin sulfate, Imipenem, Metronidazole, Monensin sodium salt, Nystatin, Ofloxacin, Sulfamethoxazole, Tetracycline, Trimethoprim naphthoate, and Vancomycin hydrochloride. The study concluded: "None of the antibiotics was readily biodegradable. Elimination in the environment by other mechanisms may happen, but will not completely mineralize the active compounds. The results of CFU determination showed that some of antibiotics have an inhibitory effect on the bacterial population. Our findings underline the need for more detailed investigating effects on antibiotics in the environment." In this study, Erythromycin was one of the drugs that had an inhibitory effect on the bacterial population.

In Drinking Water

An Associated Press investigation found that, of 62 metropolitan areas in the U.S., only 28 tested for pharmaceuticals, and 24 found pharmaceuticals in the drinking water when they tested it.[11] Of those tested, Philadelphia tested positive for erythromycin (as well as 55 other drugs).[12]

Articles and resources

Related SourceWatch articles

References

  1. PubMed Health - Erithromycin, Accessed August 28, 2010.
  2. Erythromycin: MedlinePlus Drug Information, Accessed September 2, 2010.
  3. Erythromycin Oral: Dosage, Uses, and Warnings, Accessed September 2, 2010.
  4. Erythromycin Oral: Dosage, Uses, and Warnings, Accessed September 2, 2010.
  5. Erythromycin: MedlinePlus Drug Information, Accessed September 2, 2010.
  6. Erythromycin Oral: Dosage, Uses, and Warnings, Accessed September 2, 2010.
  7. Erythromycin: MedlinePlus Drug Information, Accessed September 2, 2010.
  8. O.A.H. Jones, N. Voulvoulis, and J.N. Lester, Human Pharmaceuticals in Wastewater Treatment Processes, Environmental Science and Technology, 2005.
  9. Targeted National Sewage Sludge Survey Report, US EPA website, Accessed August 28, 2010.
  10. Radka Alexy, Tina Kümpel and Klaus Kümmerer, "Assessment of degradation of 18 antibiotics in the Closed Bottle Test", Chemosphere, November 2004.
  11. AN AP INVESTIGATION : Pharmaceuticals Found in Drinking Water, Associated Press, Accessed September 3, 2010.
  12. Pharmawater-Metros-By-Results, Associated Press, Accessed September 3, 2010.

External resources

External articles