Erythromycin
Chemical
The first macrolide
Use
- Antibiotic
- Prokinetic
Presentation
Tablets: 250/500mg
Liquid suspension: 10/25/50mg per mL
Route / Dose
PO 1 – 4g/day in divided doses
IV infusion over 60 mins
MoA
Antibiotic
- Binds reversibly to 50S of bacterial ribosomes
- Inhibits polymerisation of peptides
- BACTERICIDAL/BACTERIOSTATIC
Prokinesis
- Motilin receptor agonist (enhancing motilin release from enterochromaffin cells in duodenum)
- ↑MMC
- ↑LES tone
PD
Bactericidal/Bacteriostatic
Prokinetic
PK
A
OBA 10 – 60%
D
80% PPB
VD 0.3 – 1.2L/kg
Poor CNS penetration
M
Demethylation in liver
E
Unchanged in urine 15%
T½ = 1.6hrs
Not removed by dialysis
Adverse Effects
- QT prolongation
- P450 inhibition
∴ potentiates: Digoxin, Midazolam, Warfarin, Theophylline
- Porphyria
- Nausea, vomiting, diarrhoea