NICU and Dept. of Pharmacy
Dose and Administration1,2,3
- IV infusion by syringe pump over 60 minutes.
10 mg/kg/dose 6 hourly
12.5 mg/kg/dose 6 hourly
- Suspected/proven infection with Mycoplasma pneumoniae, Ureaplasma urealyticum, and
- As a substitute for penicillin in situations of significant hypersensitivity to penicillin.
- Treatment for and prophylaxis against Bordetella pertussis.
- Known hypersensitivity to erythromycin
- Administration to patients already taking cisapride is
- If allergic reactions, from skin eruptions to anaphylaxis, occur
discontinue erythromycin immediately.
- Prolonged use may result in superinfection. This may be
accompanied by Clostridium difficile- associated diarrhoea which may range
from mild diarrhoea to fatal pseudomembranous colitis. Discontinue
erythromycin immediately and avoid co-administration of drugs which delay
peristalsis eg. opiates.
- Prolongation of QT interval and development of ventricular arrhythmias
can occur and may be associated with too rapid administration.
- Liver disease. Caution in infants with jaundice, liver dysfunction, and
biliary tract disease.
- Caution in preterm infants, especially extreme immaturity
- Avoid concomitant use with cisapride
- Erythromycin may increase the effects of digoxin, midazolam,
corticosteroids, fentanyl, milrinone, phenytoin, rifampicin, caffeine
- Erythromycin may decrease the effect of: BCG
Bacteriostatic antibiotic which suppresses bacterial protein synthesis. The
antibacterial spectrum is similar to penicillin but extended to include
Mycoplasma pneumoniae, Ureaplasma urealyticum and Chlamydia trachomatis.
Vd 45% of body weight in adults. Antibacterial levels are achievable in all
tissues except brain and CSF. Highly bound (64-98%) to human plasma protein.
Hepatic excretion into bile as active compound. Only 5-15% of administered dose
excreted in the active form in the urine. Plasma half life equals 2-4 hours.
Possible Adverse Effects1
- Allergic reactions, cardiotoxicity , including prolongation of QT
interval, ventricular arrhythmias. See “warnings”
- More common reactions are thrombophlebitis, venous irritation, and
gastrointestinal eg. vomiting, diarrhoea. These can be avoided by
administering slowly as a diluted solution.
- Other reactions that may occur are: bradycardia, hypotension,
ototoxicity, hepatic impairment, hypertrophic pyloric stenosis.
- Monitor LFTs, B.P., heart rate.
- Hepatic dysfunction, use cautiously.
- I.V. push is not recommended due to local irritation and cardiovascular
effects. See “warnings”
- At low doses erythromycin may inhibit the effect of penicillin, but at
high doses may act synergistically.