Classifications: macrolide antibiotic; Therapeutic: antibiotic
Pregnancy Category: B
500 mg, 1 g injection
Soluble salt of erythromycin. It binds to the 50S ribosome subunits of susceptible bacteria, resulting in the suppression
of protein synthesis of bacteria.
More active against gram-positive than gram-negative bacteria.
When oral administration is not possible or the severity of infection requires immediate high serum levels. See erythromycin.
Hypersensitivity to erythromycin or macrolide antibiotics; congenital QT prolongation; electrolyte imbalances.
Impaired liver function; seizure disorders; pregnancy (category B), lactation.
Route & Dosage
Adult/Child: IV 1520 mg/kg/d in 4 divided doses
Adult: IV 0.51 g q6h x 21 d
Pelvic Inflammatory Disease
Adult: IV 500 mg q6h x 3d, then convert to PO
PREPARE: Intermittent/Continuous (preferred): Initial solution is prepared by adding 10 mL sterile water for injection without preservatives to each 500 mg or fraction
thereof. Shake vial until drug is completely dissolved. Intermittent: Further dilute each 1 g dose in 100250 mL of RL or NS. Continuous: Further dilute each 1 g in 1000 mL RL or NS. Give within 4 h.
ADMINISTER: Intermittent: Give 1 g or fraction thereof over 2060 min. Slow rate if pain develops along course of vein. Continuous: Continuous infusion is administered slowly, usually over 6 h.
INCOMPATIBILITIES Solution/additive: Dextrose-containing solutions, ascorbic acid, carbenicillin, colistimethate, clindamycin, furosemide, heparin, linezolid, metaraminol, metoclopramide, tetracycline, vitamin B complex with C. Y-site: Cefepime, ceftazidime, fluconazole.
- Store: Gluceptate, reconstituted solution is stable up to 7 d if refrigerated at 2°8° C (36°46° F);
use solution diluted for infusion within 4 h. Lactobionate, reconstituted solution is stable up to 14 d if refrigerated at 2°8° C (36°46° F); use
solution diluted for infusion within 8 h.
Adverse Effects (≥1%) Body as a Whole: Pain and venous irritation after IV injection;
allergic reactions, anaphylaxis
(rare); superinfections. GI: Nausea,
, abdominal cramps,
variations in liver function tests following prolonged or repeated therapy. (See also ERYTHROMYCIN.
levels and toxicities of alfentanil, bexarotene, carbamazepine, cevimeline, cilostazol, clozapine, cyclosporine, disopyramide, estazolam, fentanyl, midazolam, methadone, modafinil, quinidine, sirolimus, digoxin, theophylline, triazolam, warfarin
are increased. Ergotamine
may increase peripheral vasospasm. May increase risk of arrhythmias.
1 h. Distribution:
Concentrates in liver; crosses placenta; distributed into breast milk. Metabolism:
In liver. Elimination:
Primarily in bile and feces; 1215% in urine. Half-Life:
Assessment & Drug Effects
- Lab tests: Determine C&S prior to initiation of therapy. Periodic liver function tests with daily high doses or prolonged
or repeated therapy.
- Monitor hearing impairment may occur with large doses of this drug. It may occur as early as the second day and as late as
the third week of therapy.
- Monitor for S&S of thrombophlebitis (see Appendix F). IV infusion of large doses is reported to increase risk.
Patient & Family Education
- Notify physician immediately of tinnitus, dizziness, or hearing impairment.