Erythromycin has been shown to be active against most isolates of the following bacteria both in vitro and in clinical infections as described in the INDICATIONS AND USAGE section. Erythromycin has been associated with prolongation of the QT interval and infrequent cases of arrhythmia. The absence of an interaction does not necessarily mean no interactions exist. The following in vitro data are available, but their clinical significance is unknown. Mechanism of Action. Smoothie. U.S. Patent US5274085, issued October, 1966. The risk or severity of bleeding can be increased when Erythromycin is combined with Acenocoumarol. Queens of the Stone Age will bring Phantogram, Viagra Boys, the Armed, and Savages Jehnny Beth on their fall North American tour. Am J Clin Nutr. Erythromycin Tablets Prescribing Information, but their clinical significance is unknown. Consult with your doctor about any medications or supplements you may be taking and if there is potential for drug interactions with erythromycin. The Mechanism of Action. Microorganisms themselves or their toxins can damage host cells. 1998 Oct 9;358(3):289-94. Erythromycin should be avoided in patients with known prolongation of the QT interval, patients with ongoing proarrhythmic conditions such as uncorrected hypokalemia or hypomagnesemia, clinically significant bradycardia, and in patients receiving Class IA (quinidine, procainamide) or Class III (dofetilide, amiodarone, sotalol) antiarrhythmic agents. [, Gordon RC, Regamey C, Kirby WM: Serum protein binding of erythromycin, lincomycin, and clindamycin. Overdosage should be handled with the prompt elimination of unabsorbed drug and all other appropriate measures should be instituted. Antagonism exists in vitro between erythromycin and clindamycin, lincomycin, and chloramphenicol. Sometimes after starting treatment with antibiotics, patients can develop watery and bloody stools (with or without stomach cramps and fever) even as late as two or more months after having taken the last dose of the antibiotic. In case of theophylline toxicity and/or elevated serum theophylline levels, the dose of theophylline should be reduced while the patient is receiving concomitant erythromycin therapy. There have been reports of infantile hypertrophic pyloric stenosis (IHPS) occurring in infants following erythromycin therapy. Drug Metab Dispos. "Vitamn C njdete v ovoc, ako s pomarane a jahody, a Elderly patients may be more susceptible to development of torsades de pointes arrhythmias than younger patients. PO (Adults): Base, stearate 250 mg every 6 hr, or 333 mg every 8 hr, or 500 mg every 12 hr. Erythromycin has been reported to significantly alter the metabolism of the nonsedating antihistamines terfenadine and astemizole when taken concomitantly. Although the optimal duration of therapy has not been established, the recommended therapy is oral erythromycin suspension 50 mg/kg/day in 4 divided doses for at least 3 weeks. Use our structured and evidence-based datasets to unlock new insights and accelerate drug research. 1993 Aug 5;232(3):725-31. Eryc 333 mg Capsule (Enteric-Coated Pellet), Eryc 250 mg Capsule (Enteric-Coated Pellet), Erythromycin Base 250 mg Enteric Coated Capsule, Apo-Erythro E-C 333 mg Capsule (Enteric-Coated Pellet), Apo-Erythro E-C 250 mg Capsule (Enteric-Coated Pellet), https://www.chemicalbook.com/ChemicalProductProperty_US_CB8300078.aspx. Epub 2013 Sep 6. In order to replicate, bacteria require a specific process of protein synthesis, enabled by ribosomal proteins. Erythromycin has been reported to increase concentrations of HMG-CoA reductase inhibitors (e.g., lovastatin and simvastatin). Health disease, as a result. Batch CBD Full-Spectrum Gummies. Listeriosis caused by Listeria monocytogenes. (See Viagra package insert.). It stops bacterial protein synthesis by inhibiting the transpeptidation/translocation step of protein synthesis and by inhibiting the assembly of the 50S ribosomal subunit.21,10 This results in the control of various bacterial infections.13,21 The strong affinity of macrolides, including erythromycin, for bacterial ribosomes, supports their broadspectrum antibacterial activities.13, Orally administered erythromycin is readily absorbed. Erythromycin should immediately be discontinued in cases of overdose. In the presence of normal hepatic function, erythromycin is concentrated in the liver and is excreted in the bile; the effect of hepatic dysfunction on biliary excretion of erythromycin is not known. [, Kavi J, Webberley JM, Andrews JM, Wise R: A comparison of the pharmacokinetics and tissue penetration of spiramycin and erythromycin. Infants born to women treated during pregnancy with oral erythromycin for early syphilis should be treated with an appropriate penicillin regimen. Arzneimittelforschung. InChI=1S/C37H67NO13/c1-14-25-37(10,45)30(41)20(4)27(39)18(2)16-35(8,44)32(51-34-28(40)24(38(11)12)15-19(3)47-34)21(5)29(22(6)33(43)49-25)50-26-17-36(9,46-13)31(42)23(7)48-26/h18-26,28-32,34,40-42,44-45H,14-17H2,1-13H3/t18-,19-,20+,21+,22-,23+,24+,25-,26+,28-,29+,30-,31+,32-,34+,35-,36-,37-/m1/s1, (3R,4S,5S,6R,7R,9R,11R,12R,13S,14R)-6-{[(2S,3R,4S,6R)-4-(dimethylamino)-3-hydroxy-6-methyloxan-2-yl]oxy}-14-ethyl-7,12,13-trihydroxy-4-{[(2R,4R,5S,6S)-5-hydroxy-4-methoxy-4,6-dimethyloxan-2-yl]oxy}-3,5,7,9,11,13-hexamethyl-1-oxacyclotetradecane-2,10-dione, CC[C@H]1OC(=O)[C@H](C)[C@@H](O[C@H]2C[C@@](C)(OC)[C@@H](O)[C@H](C)O2)[C@H](C)[C@@H](O[C@@H]2O[C@H](C)C[C@@H]([C@H]2O)N(C)C)[C@](C)(O)C[C@@H](C)C(=O)[C@H](C)[C@@H](O)[C@]1(C)O, Use our structured and evidence-based datasets to. Patients should be given clear instructions regarding the use of sildenafil. Most Infections. (See CONTRAINDICATIONS.). [8] 2002 Jun;44(6):418-24. [, Sun H, Huang Y, Frassetto L, Benet LZ: Effects of uremic toxins on hepatic uptake and metabolism of erythromycin. [, Schlunzen F, Zarivach R, Harms J, Bashan A, Tocilj A, Albrecht R, Yonath A, Franceschi F: Structural basis for the interaction of antibiotics with the peptidyl transferase centre in eubacteria. The molecular formula is C37H67NO13, and the molecular weight is 733.94. The serum concentration of Abemaciclib can be increased when it is combined with Erythromycin. Erythromycin crosses the placental barrier, but fetal plasma levels are low. Technically, antibiotic refers only to antimicrobials derived from bacteria or molds but is often (including in THE MANUAL) used synonymously with antibacterial drug.. Cases of torsades de pointes have been spontaneously reported during postmarketing surveillance in patients receiving erythromycin. J Int Med Res. Erythromycin Tablets, USP, NDC 67877-763-30 3 Answers. Rare cases of serious cardiovascular adverse events, including electrocardiographic QT /QTc interval prolongation, cardiac arrest, torsades de pointes, and other ventricular arrhythmias, have been observed. Drug Metab Dispos. Medically reviewed by Drugs.com. This interaction is potentially life-threatening, and may occur while using both drugs at their recommended doses (see PRECAUTIONS - Drug Interactions). A. [, Kalliokoski A, Niemi M: Impact of OATP transporters on pharmacokinetics. Penicillin is considered by the American Heart Association to be the drug of choice in the prevention of initial attacks of rheumatic fever (treatment of Streptococcus pyogenes infections of the upper respiratory tract e.g., tonsillitis, or pharyngitis).1 Erythromycin is indicated for the treatment of penicillin-allergic patients. 1977 Oct;17(10 Pt 1):592-600. Generic Name Sulfanilamide DrugBank Accession Number DB00259 Background Sulfanilamide is a molecule containing the sulfonamide functional group attached to an aniline. Last updated on Jul 1, 2022. Erythromycin is indicated to treat pertussis (whooping cough) caused by Bordetella pertussis. Improve clinical decision support with information on. [. Food intake does not appear to exert effects on serum concentrations of erythromycin.21 Some interindividual variation exists in terms of erythromycin absorption, which may impact absorption to varying degrees.21 The Cmax of erythromycin is 1.8 mcg/L15 and the Tmax is 1.2 hours.19 The serum AUC of erythromycin after the administration of a 500mg oral dose was 7.33.9 mg.h/l in one pharmacokinetic study.19 Erythromycin is well known for a bioavailability that is variable (18-45%) 6,14 after oral administration and its susceptibility to broken down under acidic conditions.5, Erythromycin is found in most body fluids and accumulates in leucocytes and inflammatory liquid.21,5,19 Spinal fluid concentrations of erythromycin are low, however, the diffusion of erythromycin through the blood-brain barrier increases in meningitis, likely due to the presence of inflamed tissues which are easily penetrated.22 Erythromycin crosses the placenta.21, Erythromycin demonstrates 93% serum protein binding in the erythromycin propionate form.7 Another resource indicates that erythromycin protein binding ranges from 80 to 90%.18, Hepatic first-pass metabolism contributes significantly to erythromycin metabolism after an oral dose.11 Erythromycin is partially metabolized by CYP3A4 enzyme to N-desmethylerythromycin.21,8 Erythromycin is also hydrolyzed to anhydro forms (anhydroerythromycin [AHE] and other metabolites), and this process is promoted by acidic conditions.5 AHE is inactive against microbes but inhibits hepatic drug oxidation and is therefore considered to be an important contributor to erythromycin drug-drug interactions.5, Hover over products below to view reaction partners, In patients with normal liver function, erythromycin concentrates in the liver and is then excreted in the bile.22Under 5% of the orally administered dose of erythromycin is found excreted in the urine.22,19 A high percentage of absorbed erythromycin is not accounted for, but is likely metabolized.22, The elimination half-life of oral erythromycin was 3.5 hours according to one study6 and ranged between 2.4-3.1 hours in another study.15 Repetitive dosing of erythromycin leads to increased elimination half-life.16, The clearance of erythromycin in healthy subjects was 0.53 0.13 l/h/kg after a 125mg intravenous dose.11 In a clinical study of healthy patients and patients with liver cirrhosis, clearance of erythromycin was significantly reduced in those with severe liver cirrhosis.17 The clearance in cirrhotic patients was 42.2 10.1 l h1 versus 113.2 44.2 l h-1 in healthy patients.17, The oral LD50 of erythromycin in rats is 9272 mg/kg.23, Symptoms of overdose may include diarrhea, nausea, stomach cramps, and vomiting. Generic Name. It is basic and readily forms salts with acids. Dosage adjustments may be considered, and when possible, serum concentrations of drugs primarily metabolized by CYP3A should be monitored closely in patients concurrently receiving erythromycin. The most frequent side effects of oral erythromycin preparations are gastrointestinal and are dose-related. [, Wahab HA, Yam WK, Samian MR, Najimudin N: Refinement of a low-resolution crystal structure to better understand erythromycin interactions on large ribosomal subunit. A significant increase in colchicine plasma concentration is anticipated when co-administered with moderate CYP3A4 inhibitors such as erythromycin. Antibiotics commonly are produced by soil microorganisms and probably represent a means by which organisms in a complex environment, such as soil, control the growth of competing microorganisms. Viagra does not result in an erection without sexual stimulation. They include nausea, vomiting, abdominal pain, diarrhea and anorexia. 2017 Sep;174(18):2967-2983. doi: 10.1111/bph.13936. [, Konig J: Uptake transporters of the human OATP family: molecular characteristics, substrates, their role in drug-drug interactions, and functional consequences of polymorphisms. Photo: Andreas Neumann. Napumpujte ho antioxidantmi a vitamnmi! 2004 Nov;32(11):1239-46. Store at 20C to 25C (68F to 77F); excursions permitted between 15C to 30C (59F to 86F) [see USP Controlled Room Temperature]. Drug Metab Dispos. Skin and skin structure infections of mild to moderate severity caused by Streptococcus pyogenes or Staphylococcus aureus (resistant staphylococci may emerge during treatment). The mechanism by which this interaction occurs is unknown. [, Garza-Ramos G, Xiong L, Zhong P, Mankin A: Binding site of macrolide antibiotics on the ribosome: new resistance mutation identifies a specific interaction of ketolides with rRNA. Un programa que dej de tener gracia cuando (erythromycin lactobionate for injection, USP) every 6 hours for 3 days, followed by 500 mg of erythromycin base orally every 12 hours for 7 days. Fatalities have been reported. The first look at the 'middle aged Love Island' set has been released, which has already been nicknamed the 'Viagra House' by locals after single parents searched for love Clinical studies suggest that erythromycin may aid in the prevention of pertussis infection for individuals who have been exposed to the bacteria.21 Respiratory tract infections due to Mycoplasma pneumoniae may also be treated with erythromycin.21 Despite the fact that no controlled clinical efficacy studies have been conducted to this date, in vitro and certain preliminary clinical study results indicate that erythromycin may be an effective treatment in Legionnaires Disease.21 Finally, erythromycin is indicated to treat diphtheria and other infections due to Corynebacterium diphtheriae, as an adjunct to antitoxin, to prevent carrier status and to eradicate the organism in existing carriers.21 In addition to the prevention of diphtheria, erythromycin can be used to prevent rheumatic fever in penicillin intolerant patients.21, Mild to moderate skin or skin structure infections caused by Streptococcus pyogenes or Staphylococcus aureus may be treated with erythromycin, however, resistant staphylococcal organisms may emerge.21 Erythromycin can also be used to treat erythrasma, an infectious condition caused by Corynebacterium minutissimum.21, Intestinal amebiasis caused by Entamoeba histolytica can be treated with oral erythromycin. Optimal blood levels are obtained when Erythromycin Tablets are given in the fasting state (at least 1/2 hour and preferably 2 hours before meals). These medicines prevent an enzyme called phosphodiesterase type-5 from working too quickly. [, Crumb WJ Jr: Allosteric effects of erythromycin pretreatment on thioridazine block of hERG potassium channels. Interindividual variations in the absorption of erythromycin are, however, observed, and some patients do not achieve optimal serum levels. 30 to 40 g given in divided doses over a period of 10 to 15 days. 1989 Sep;257(3 Pt 1):G470-4. Sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis) and avanafil (Stendra) are oral medications that reverse erectile dysfunction by enhancing the effects of nitric oxide, a natural chemical your body produces that relaxes muscles in the penis. (See ADVERSE REACTIONS and DOSAGE AND ADMINISTRATION). Skin reactions ranging from mild eruptions to erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis have been reported rarely. 2011;(201):1-28. doi: 10.1007/978-3-642-14541-4_1. Prolonged or repeated use of erythromycin may result in an overgrowth of nonsusceptible bacteria or fungi. Do not use erythromycin concomitantly with HMG CoA reductase inhibitors (statins) that are extensively metabolized by CYP 3A4 (lovastatin or simvastatin), due to the increased risk of myopathy, including rhabdomyolysis. Curr Microbiol. Batch CBD Full-Spectrum Gummies. In most cases, it takes about 5 half-lives for your body to completely remove a [, Klotz U: Interaction potential of lercanidipine, a new vasoselective dihydropyridine calcium antagonist. The Lancet 1999:354 (9196): 2101-5. Antimicrob Agents Chemother. [, Lancaster CS, Bruun GH, Peer CJ, Mikkelsen TS, Corydon TJ, Gibson AA, Hu S, Orwick SJ, Mathijssen RH, Figg WD, Baker SD, Sparreboom A: OATP1B1 polymorphism as a determinant of erythromycin disposition. The following are examples of some clinically significant CYP3A based drug interactions. 2007 Mar;35(3):484-92. doi: 10.1124/dmd.106.011304. This means that 4 hours after you take a dose, your body has cleared half of the dose. Mechanism of action. Other diseases of the janelsins mc et al. Colchicine is a substrate for both CYP3A4 and the efflux transporter P-glycoprotein (P-gp). Erythromycin Tablets, USP are indicated in the treatment of infections caused by susceptible strains of the designated microorganisms in the diseases listed below: Upper respiratory tract infections of mild to moderate degree caused by Streptococcus pyogenes; Streptococcus pneumoniae; Haemophilus influenzae (when used concomitantly with adequate doses of sulfonamides, since many strains of H. influenzae are not susceptible to the erythromycin concentrations ordinarily achieved). Therefore, the physician should consider this diagnosis in patients with diarrhea after the administration of antibacterial agents.21 Erythromycin can cause hepatic dysfunction, cholestatic jaundice, and abnormal liver transaminases, particularly when erythromycin estolate is administered.22, In order to replicate, bacteria require a specific process of protein synthesis, enabled by ribosomal proteins.9 Erythromycin acts by inhibition of protein synthesis by binding to the 23S ribosomal RNA molecule in the 50S subunit of ribosomes in susceptible bacterial organisms. Inhibits RNA-dependent protein synthesis at the chain elongation step; binds to the 50S ribosomal Elderly patients may be more susceptible to drug-associated effects on the QT interval. [, Krasniqi S, Matzneller P, Kinzig M, Sorgel F, Huttner S, Lackner E, Muller M, Zeitlinger M: Blood, tissue, and intracellular concentrations of erythromycin and its metabolite anhydroerythromycin during and after therapy. "Vitamn C njdete v ovoc, ako s pomarane a jahody, a (See package insert for lovastatin.). Patients should have a serologic test for syphilis before receiving erythromycin as treatment of gonorrhea and a follow-up serologic test for syphilis after 3 months. (See PRECAUTIONS - Drug Interactions.). The serum concentration of Acetaminophen can be increased when it is combined with Erythromycin. 2003 Jan;55(1):86-93. [, Wang LQ, Hu ZY, Yu Q, Guo X, Xiong J, Huang ZZ, Cheng ZN: [Pharmacokinetics of erythromycin stinoprate capsule]. It is indicated as an alternative option to tetracyclines for the treatment of uncomplicated rectal, urethral and endocervical infections in adults caused by Chlamydia trachomatis.21 Erythromycin can be used in nongonococcal urethritis can be used when tetracyclines cannot be administered. Phenoxymethylpenicillin. Erythromycin can also be used in the primary stage of primary syphilis.21 Another approved indication of erythromycin is to treat chlamydial infections that cause conjunctivitis of the newborn, pneumonia of infancy, and urogenital infections occurring in pregnancy. They do not treat viral infections (e.g., the common cold). Sildenafil belongs to a group of medicines called phosphodiesterase 5 (PDE5) inhibitors. In case of overdosage, erythromycin should be discontinued. Rapid elimination of unabsorbed drug should be attempted. Type Small Molecule Groups Approved There have been post-marketing reports of colchicine toxicity with concomitant use of erythromycin and colchicine. Clin Pharmacol Ther. J Biomol Struct Dyn. Smoothie. Staphylococcus aureus (resistant organisms may emerge during treatment). The current In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. [, Franke RM, Baker SD, Mathijssen RH, Schuetz EG, Sparreboom A: Influence of solute carriers on the pharmacokinetics of CYP3A4 probes. The serum concentration of Acalabrutinib can be increased when it is combined with Erythromycin. WebThis review intends to discuss the mechanism of action and resistance development in commonly used antimicrobials. When indicated, incision and drainage or other surgical procedures should be performed in conjunction with antibiotic therapy. Includes Erythromycin (Systemic) indications, dosage/administration, pharmacology, mechanism/onset/duration of action, half-life, dosage forms, interactions, warnings, adverse reactions, off-label uses and more. 15 In addition, deaths have been reported rarely with concomitant administration of terfenadine and erythromycin. [, Mather LE, Austin KL, Philpot CR, McDonald PJ: Absorption and bioavailability of oral erythromycin. It is important to note that Staphylococci that are resistant to erythromycin may emerge during erythromycin and/or sulfonamide therapy.21 Pseudomembranous colitis has been reported with most antibacterial agents, including erythromycin, and may range in severity from mild to life-threatening. Erythromycin has been reported to increase the systemic exposure (AUC) of sildenafil. Erythromycin is not removed by peritoneal dialysis or hemodialysis. 2011 May;89(5):693-701. doi: 10.1038/clpt.2011.25. He armed himself with a balaclava, latex gloves, condoms and Viagra pills and posed as a cab driver in a Mercedes to roam the streets of Brighton, East Sussex. Concomitant administration of erythromycin with ergotamine or dihydroergotamine is contraindicated (see CONTRAINDICATIONS). (See appropriate sulfonamide labeling for prescribing information.). Below, check out the tour dates, Erythromycin is contraindicated in patients with known hypersensitivity to this antibiotic. PDEs comprise a diverse family of enzymes that If superinfection occurs, erythromycin should be discontinued and appropriate therapy instituted. Erythromycin Tablets, USP, NDC 67877-762-05 Fatalities have been reported. For more severe infections this dosage may be doubled but should not exceed 4 g per day. There have been reports of interstitial nephritis coincident with erythromycin use. Pertussis (whooping cough) caused by Bordetella pertussis. Finally, erythromycin is indicated to treat nongonococcal urethritis due to Ureaplasma urealyticum.21, Macrolides, such as erythromycin, stop bacterial growth by inhibiting protein synthesis and translation, treating bacterial infections.8 Erythromycin does not exert effects on nucleic acid synthesis.21 This drug has been shown to be active against most strains of the following microorganisms, effectively treating both in vitro and clinical infections. Similar to other macrolide antibiotics, the main objective of AZM is inhibiting bacterial protein synthesis by targeting the 50S subunit of the sensitive bacterial ribosome (Figure 2).The reduction in protein synthesis is correlated with the increase in macrolide concentration. 2008 Dec;84(6):704-9. doi: 10.1038/clpt.2008.94. The structural formula is: croscarmellose sodium, crospovidone, D&C red #30/helendon pink aluminum lake, hydroxypropyl cellulose, hypromellose phthalate, hypromellose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, povidone, propylene glycol, silicon dioxide, sodium citrate dehydrate, sodium hydroxide pellets, sorbitan monooleate, talc and titanium dioxide. Erythromycin Tablets, USP, 500 mg are supplied as pink, oval shaped, film coated tablet, debossed with E5 on one side and plain on other side. ), Erythromycin has been associated with QT prolongation and ventricular arrhythmias, including ventricular tachycardia and torsades de pointes. There have been spontaneous or published reports of CYP3A based interactions of erythromycin with cyclosporine, carbamazepine, tacrolimus, alfentanil, disopyramide, rifabutin, quinidine, methyl-prednisolone, cilostazol, vinblastine, and bromocriptine. WebPhenoxymethylpenicillin. He armed himself with a balaclava, latex gloves, condoms and Viagra pills and posed as a cab driver in a Mercedes to roam the streets of Brighton, East Sussex. J Mol Biol. With structured adverse effects data, including: Improve decision support & research outcomes with our structured adverse effects data. In sacubitril/valsartan 19/51 mg twice daily therapy. Br J Clin Pharmacol. Biochimie. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. The major route of resistance is modification of the 23S rRNA in the 50S ribosomal subunit to insensitivity while efflux can also be significant. DrugBank Accession Number. Erythromycin displays bacteriostatic activity or inhibits growth of bacteria, especially at higher concentrations, but the mechanism is not fully understood. Br J Clin Pharmacol. This action WebErythromycin is produced by a strain of Saccharopolyspora erythraea (formerly Streptomyces erythraeus) and belongs to the macrolide group of antibiotics. NDC 67877-762-30 Extraenteric amebiasis requires treatment with other agents. 2014 Apr;171(7):1668-75. doi: 10.1111/bph.12575. Epub 2016 Jan 27. [, Padda MS, Sanchez M, Akhtar AJ, Boyer JL: Drug-induced cholestasis. Sildenafil belongs to a class of compounds called PDE inhibitors. 1980;8 Suppl 2:9-14. It does not affect nucleic acid synthesis. WebMechanism of Action. (See also Antibiotics in Neonates .) [, Pedersen JM, Matsson P, Bergstrom CA, Hoogstraate J, Noren A, LeCluyse EL, Artursson P: Early identification of clinically relevant drug interactions with the human bile salt export pump (BSEP/ABCB11). One of the most well known fooddrug interactions is grapefruit juice and the HMG-CoA reductase inhibitors, more commonly known as statins. Int J Clin Pharmacol Ther. 10. [, Barre J, Mallat A, Rosenbaum J, Deforges L, Houin G, Dhumeaux D, Tillement JP: Pharmacokinetics of erythromycin in patients with severe cirrhosis. Erythromycin acts by inhibition of protein synthesis by binding 50S ribosomal subunits of susceptible organisms. Erythromycin is a substrate and inhibitor of the 3A isoform subfamily of the cytochrome p450 enzyme system (CYP3A). Class. We comply with the HONcode standard for trustworthy health information. Prescribing Erythromycin Tablets in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria. Effects of age and various pathophysiological states (Part I). Honein, M.A., et al. 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