| A-MYCIN
Erythromycin
Description:
A-Mycin
(Erythromycin) is a macrolide antibiotic, which may be bactericidal
or bacteriostatic. Erythromycin binds to the 50S ribosomal subunit
of susceptible bacteria and suppresses protein synthesis without
affecting nucleic acid synthesis.
A-Mycin
(Erythromycin) is usually active against following organisms:
Gram positive: Staphylococcus aureus, Streptococcus Pyogenes,
S. pneumoniae, Corynebacterium diphtheriae, C. minutissimum.
Gram-negative: Moraxella catarrhalis, Neisseria gonorrhoeae,
Legionella pneumophila, Bordetella pertussis. Mycoplasma:
Mycoplasma pneumoniae, Ureoplasma urealyticum. Others:
Chlamydia trachomatis, Eantamoeba histolytica, Treponema
pallidum, Listeria monocytogenes.
Composition:
A-Mycin
Tablet: Each enteric coated tablet contains Erythromycin
BP 250 mg.
A-Mycin-500
Tablet: Each enteric coated tablet contains Erythromycin
BP 500 mg.
A-Mycin
Powder for Suspension: After reconstitution each 5 ml
suspension contains Erythromycin Ethylsuccinate USP equivalent
to 125 mg of Erythromycin.
A-Mycin DS Powder for Suspension: After reconstitution each 5 ml suspension contains Erythromycin Ethylsuccinate USP equivalent to 250 mg of Erythromycin.
A-Mycin
Paediatric Drops: After reconstitution each 5 ml suspension
contains Erythromycin Ethylsuccinate USP equivalent to 200 mg
of Erythromycin.
Indications:
A-Mycin
is highly effective in the treatment of a wide variety of clinical
infections, such as (1) Upper respiratory tract infections:
Tonsillitis, peritonsillar abscess, pharyngitis, laryngitis,
sinusitis, and secondary infections in colds and influenza.
(2) Lower respiratory tract infections: Tracheitis, acute and
chronic bronchitis. Mycoplasma pneumoniae (lobar pneumonia,
broncho pneumonia, primary atypical pneumoniae), bronchiectasis.
(3) Skin and soft tissue infections: Boils and carbuncles, paronychia,
abscesses, pustular acne, impetigo, cellulitis, furuncolosis,
erythrasma. (4) Veneral infections: Non-specific urethritis,
syphilis (if the patient is allergic to penicillin). (5) Gastro-intestinal
infections: Cholecystitis, Staphylococcal enterocolitis, infectious
diarrhoea, & cholera. (6) Ear and oral infections: Otitis
media and otitis externa, gingivitis, dental abscesses. (7)
Prophylaxis: Pre-operative and post-operative, trauma, burns,
rheumatic fever. (8) Other infections: Diphtheria, whooping
cough.
Dosages &
administration:
Adults: Usually
250 mg every 6 hours, or 500 mg every 12 hours. May increase
up to ≥ 4 g/day, according to severity of infection.
| Infections |
Dosage and Administration |
| Upper respiratory tract infections of mild to moderate
severity |
250 to 500 mg 4 times a day for 10 days |
| Lower respiratory infections of mild to moderate
severity |
250 to 500 mg 4 times a day for 10 days |
| Respiratory tract infections due to Mycoplasma
pneumoniae |
500 mg 6 hours for 5 to 10 days, treat severe infections
for up to 3 weeks |
| Skin and soft tissue infections of mild to moderate
severity |
250 to 500 mg 4 times a day for 10 days |
| Pelvic inflammatory diseases (PID), acute
due to Neisseria gonorrhoeae |
500 mg 4 times a day for 10 to 14 days |
| Urogenital infection during pregnancy caused by Chlamydia
trachomatis |
500 mg 4 times daily for 7 days or 250 mg 4 times
daily for 14 days |
| Urethral, endocervical or rectal infections, uncomplicated |
500 mg 4 times daily for 7 days or 250 mg 4 times
daily for 14 days |
| Non-gonococcal urethritis |
500 mg 4 times daily for at least 7 days |
| Neisseria gonorrhoeae:
Uncomplicated urethral, endocervical or rectal infections
and in penicillinase producing N. gonorrhoeae
(PPNG) |
500 mg 4 times a day for 7 days |
| Early syphillis (primary, secondary or latent syphillis
of < 1 year duration) |
500 mg 4 times a day for 14 days |
| Severe or chronic diarrhoea |
500 mg 4 times a day for 7 days |
| Rheumatic fever |
250 mg 2 times daily |
| Bacterial endocarditis |
1 g 2 hours prior to procedures, then 500 mg 6 hours
after initial dose |
| Acne |
500 mg twice daily for 3 months reduced to 250 mg
twice for 3 months |
Children:
The usual oral dose is 30-50 mg/kg body weight per day in divided
doses. For more severe infections, the dose may be doubled.
Adverse Effects:
Gastro-intestinal:
abdominal cramp & discomfort, nausea, vomiting & diarrhoea.
Hypersensitivity reaction may also be responsible for the hepatotoxicity
sometimes in patients receiving A-Mycin (Erythromycin)
or its derivatives.
Precautions
& Warnings:
All forms of A-Mycin
(Erythromycin) should be used with care in patients with existing
hepatic impairment. It has been suggested that A-Mycin
(Erythromycin) should be used with care in patients with history
of arrhythmias.
Drug Interactions:
A-Mycin
(Erythromycin) may decrease the clearance of theophylline causing
increased theophylline serum level and potential toxicity. It
may decreases the metabolism of carbamazepine, triazolam, hexobarbital
and phenytoin causing increased serum levels and potential toxicity.
A-Mycin (Erythromycin) may decrease the clearance of
warfarin and thus potentiate the hypoprothrombinic effect of
warfarin.
Use in Pregnancy
and Lactation:
A-Mycin
(Erythromycin) crosses the placenta. Fetal plasma concentrations
are variously stated to the 5 to 20% of these in the mother.
It is readily excreted in breast milk.
Contraindications:
A-Mycin
(Erythromycin) is contraindicated in patients with known hypersensitivity
of this antibiotic.
Packing:
A-Mycin
Tablet: Box containing 10X10's tablets in blister pack.
A-Mycin-500
Tablet: Box containing 5X10's tablets in blister pack.
A-Mycin
Powder for suspension: Bottle containing dry powder for
reconstitution of 100 ml suspension.
A-Mycin
DS Powder for suspension: Bottle containing dry powder for
reconstitution of 100 ml suspension.
A-Mycin
Paediatric Drops: Bottle containing dry powder for reconstitution
of 60 ml suspension with dropper.
|
