ERITROCINA ® Erythromycin
ERITROCINA ® is a drug based on Erythromycin ethylsuccinate
THERAPEUTIC GROUP: Antibacterials - Macrolides
Indications Erythromycin © Erythromycin
Erythrocin © is an antibiotic useful in the treatment of infections of the upper and lower airways, skin, soft tissues sustained by sensitive germs such as Mycoplasma pneumoniae, Diplococcus pneumoniae, Staphylococcus aureus, Streptococcus pneumoniae, Bordetella pertossi.
This antimicrobial chemotherapy is also indicated in the short-term prophylaxis of bacterial endocarditis due to alpha haemolytic streptococci.
Mechanism of action ERITROCIN © Erythromycin
ERITROCINA © is an antibiotic based on erythromycin, an active ingredient belonging to the category of macrolides and characterized by a macrocyclic lactonic ring with 14 carbon atoms.
Taken orally, and made stable in an acidic environment by the addition of ethylsuccinate, it is absorbed by the enteric mucosa reaching its plasma peak from 1 to 4 hours after oral administration, being distributed, bound to plasma proteins, to the various tissues where, after having carried out the its therapeutic action with a half-life between 90 and 120 minutes, is eliminated mainly by the biliary route following demethylation carried out by cytochromial enzymes CYP3A4.
The bacteriostatic activity is carried out through the inhibition of protein synthesis, guaranteed by the bond to the 50S ribosomal subunit which exerts a steric hindrance such as to prevent the bond with the peptidyltransferase, an enzyme responsible for elongating the peptide chain by joining the various amino acids of the nascent chain .
Despite the good therapeutic efficacy, different microorganisms have developed resistance mechanisms characterized by:
- Synthesis of efflux pumps that prevent the antibiotic from reaching therapeutic concentrations inside the cell;
- Modification of the biological target;
- Enzymatic inactivation of the drug.
Studies carried out and clinical efficacy
1. THE "EFFECTIVENESS OF Erythromycin in MYCOPLASMA PNEUMONIAE INFECTIONS
Eur J Epidemiol. 1996 Apr; 12: 131-4.
Community outbreak of acute respiratory infection by Mycoplasma pneumoniae.
Domínguez A, Minguell S, Torres J, Serrano A, Vidal J, Salleras L.
Study that demonstrates the efficacy of erythromycin in the treatment of Mycoplasma pneumoniae infections, potentially dangerous especially for small patients under the age of 5 years, in which however it is possible to observe some adverse reactions to drug therapy such as hypertrophic pyloric stenosis.
The cost / benefit ratio should therefore always be considered
2 . ERITHROMYCIN AS A PROCINETIC AGENT IN PREMATURE
Arch Dis Child Fetal Neonatal Ed. 2001 May; 84: F177-F182.
Randomized controlled study of oral erythromycin for treatment of gastrointestinal dysmotility in preterm infants
P Ng, K So, K Fung, C Lee, T Fok, E Wong, W Wong, K Cheung, and A Cheng
Experimental study demonstrating the efficacy of oral erythromycin treatment not as an antibiotic but as a prokinetic agent in premature babies with severe intestinal dysmotility.
3.ABUSE OF ANTIBIOTICS IN THE VETERINARY FIELD
Antimicrob Agents Chemother. 2000 February; 44: 267-271.
Antibiotic Resistance in Campylobacter Strains Isolated from Animals, Foods, and Humans in Spain in 1997-1998
Yolanda Sáenz, 1 Myriam Zarazaga, 1 Marta Lantero, 2 M. José GastaÃ ± ares, 2 Fernando Baquero, 3 and Carmen Torres1, *
Yet another study that demonstrates the presence in foods of animal origin of microorganisms resistant to antibiotics used in medical therapy such as "erythromycin. The abuse of antibiotics in veterinary and agricultural fields represents a serious problem capable of increasing the number of resistant species, therefore to reduce the therapeutic efficacy.
Method of use and dosage
200 mg chewable tablets of erythromycin;
600 mg coated tablets of erythromycin;
Granules for oral suspension of 500 - 1000 mg of erythromycin;
10% reconstituted suspension of erythromycin.
The dosage schedule obviously depends on the physio-pathological characteristics of the patient, such as age, comorbidities, severity of the clinical picture, general health condition and the chosen pharmaceutical format.
Generally in adults it is recommended to take one tablet of 600 mg 3 times a day or one sachet of 1000 mg twice a day.
Warnings ERITROCIN © Erythromycin
The hepatic metabolism and biliary excretion that characterize the elimination pharmacokinetics of erythromycin could lead to disturbances in liver function following prolonged intakes over time.
Likewise, disturbances in liver function could seriously compromise the pharmacokinetic characteristics of the antibiotic by varying both the therapeutic efficacy and the safety profile.
The use of erythromycin © in pediatric age should be carefully evaluated by the physician taking seriously into consideration the side effects associated with erythromycin therapy as well as the choice of the appropriate format is up to the physician based on the physio-pathological situation of the patient and the severity of the his clinical picture.
Generally, one or two drops of eye drops 3-4 times a day or 3-4 daily applications of ophthalmic ointment are recommended.
PREGNANCY AND BREASTFEEDING
The use of ERITROCINA © during pregnancy and in the subsequent period of breastfeeding should be limited to cases of real and inevitable necessity, always under the supervision of your gynecologist.
It is useful to remember how the hepatic metabolism typical of erythromycin could subject the active principle to pharmacokinetic variations linked to the administration of other drugs substrates of cytochromial enzymes.
Therefore it would be advisable to pay the utmost attention to the simultaneous administration of Carbamazepine, Ciclosporin, Phenytoin, Esobarbital, Terfenadine, Triazolam, Ergotamine, Digoxin and other oral anticoagulants.
Contraindications Erythrocin © Erythromycin
Erythrocin © is contraindicated in patients with hypersensitivity to the active substance or to one of its excipients.
Undesirable Effects - Side Effects
Erythrocin © therapy could lead to the onset of gastrointestinal reactions such as cramps, abdominal pain, nausea, vomiting and diarrhea, liver dysfunction with increased transaminases and cholestatic hepatitis.
Clinically relevant allergic manifestations have only rarely been observed and infantile hypertrophic pyloric stenosis in children.
ERITROCINA © is a drug subject to mandatory medical prescription.
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