Erythromycin and macrolides

Classification

Erythromycin belongs to the antibiotic group of macrolides. In this group of substances there are four frequently administered drugs. Erythromycin is also known under the trade names ErythrocinR and PaediatrocinR.

It is an older standard antibiotic which has an acid stability and for this reason can be administered as a tablet. It is absorbed sometimes faster, sometimes slower depending on the diet. The drug has a very short half-life (2 hours), i.e. after 2 hours half of the substance is no longer detectable.

Effect

Erythromycin works by inhibiting the protein synthesis of the bacteria and thus leads to the killing of the germs. The drug has good tissue mobility and can unfold its effect in the cells relatively quickly. In contrast, it is not permeable to cerebral fluid (liquor).

This means that erythromycin is rather ineffective against bacterial diseases affecting the brain or the brain appendages (e.g. meningitis) and should not be used. Unfortunately, erythromycin can cause a rapid development of resistance. This means that some germs do not react to the administration of erythromycin after treatment. In this case the medication must be changed.

Fields of application

In the gram-negative range erythromycin is effective against Neisseria, Bordetella pertussis, Legionella and Haemophilus influenzae. In the gram-positive range it is effective against Streptococcus pyogenes, Streptococcus pneumoniae and Streptococcus faecalis, Listeria, Actinomycetes and Clostridia. Furthermore Erythromycin is still effective against mycoplasma, chlamydia and ureaplasma.

Erythromycin is often used for patients with penicillin allergy, acute respiratory tract infections that have occurred in non-residential settings (acquired on an outpatient basis), ENT and lung infections, tonsillitis, sinusitis, otitis media and whooping cough. In atypical pneumonia caused by the germs mycoplasma, chlamydia and legionella it is also often given. Erythromycin is even the first agent of choice for Legionella infections of the lungs.

The drug is also used for skin infections and diseases of the urinary tract. Macrolides are used in pediatrics and in the treatment of pregnant patients and are one of the few antibiotics that are readily available for these patient groups. For external use, erythromycin is mainly found in eye ointments to relieve inflammation.