Erythromycin

C. diff Risk

None

Oral Bioavailability

Moderate

Dosing

250 -500 mg PO q6h

There is no oral liquid suspension of erythromycin available in Canada.

At the IWK, the only format available is erythromycin (as base) 250 mg tablets. Consider use of another macrolide (as appropriate) for infectious disease indications.
30-50 mg/kg/24h PO divided q6-8h
Maximum: 2 g/24h

Oral route is preferred for infectious disease indications3.75-12.5 mg/kg/dose IV q6h
Maximum: 1000 mg/dose

There is no erythromycin oral suspension available in Canada. For information on the use of a macrolide for infectious diseases in neonatal population, please refer to azithromycin.

Reduce dose in renal impairment or need for caution.

Erythromycin use has been associated with an increased risk of hypertrophic pyloric stenosis in term infants less than 14 days of age.

General Information

Common Usage

Pertussis, Chlamydial infections, mycobacterial infections, latency in pregnancy

Drug Monitoring

Monitor QTc in patients with increased risk.

Adverse Effects

  • GI upset, diarrhea

  • Prolongation of QTc interval

Major Interactions

Substrate of CYP3A4. Multiple CYP450 interactions possible - consult a pharmacist for more detail. May increase digoxin, carbamazepine level. Caution with QTc prolonging medications

Oral Liquids

Not available

Tablet/Capsule Strengths

250 mg tablet
Tablets and capsules are preferred especially over an unpleasant tasting liquid.
Not all strengths of oral tablets/capsules are listed and they are not all available on the IWK formulary

Additional Information

Erythromycin use has been associated with an increased risk of hypertrophic pyloric stenosis in term infants less than 14 days of age.

Pharmacology

Antimicrobial class: Macrolide

Route of Elimination: Primarily hepatic