Erythromycin ethylsuccinate is an antibiotic medication prescribed to address various bacterial infections. It belongs to a class of drugs known as macrolide antibiotics. This medication is available in several forms, including tablets, capsules, and oral suspensions, making it suitable for different patient needs.
How Erythromycin Ethylsuccinate Fights Infections
Erythromycin ethylsuccinate functions by targeting and disrupting the protein synthesis machinery within bacteria. As a macrolide antibiotic, it binds to a specific subunit of the bacterial ribosome, which is the site where proteins are manufactured. This binding action prevents the bacterial ribosome from properly creating the proteins it needs to grow and multiply. By inhibiting protein synthesis, erythromycin ethylsuccinate effectively halts the spread of the infection.
The medication primarily exerts a bacteriostatic effect, meaning it inhibits the growth and proliferation of bacteria rather than directly killing them. Under certain conditions and at higher concentrations, it can exhibit bactericidal activity against specific pathogens. This mechanism makes erythromycin ethylsuccinate effective against a range of bacteria, including both gram-positive and some gram-negative types. Macrolides do not work against viral infections.
Common Uses and Proper Administration
Erythromycin ethylsuccinate is commonly prescribed for a variety of bacterial infections affecting different body systems. It is used to treat certain upper and lower respiratory tract infections, such as pneumonia caused by Mycoplasma pneumoniae or infections from Streptococcus pyogenes and Streptococcus pneumoniae. The antibiotic also treats skin and skin structure infections of mild to moderate severity. Additionally, it is indicated for conditions like pertussis, also known as whooping cough, and certain sexually transmitted infections such as syphilis and chlamydia.
This medication is available in oral forms like tablets, capsules, and suspensions. For adults, a typical dosage might be 400 mg every six hours, though this can be increased up to 4 grams per day depending on the infection’s severity. Pediatric dosing is usually based on weight, with children often receiving 30 to 50 mg per kilogram of body weight per day, divided into equally spaced doses. While it can be taken without regard to meals, absorption may be best when taken on an empty stomach.
It is important to follow the prescribing doctor’s instructions precisely and to complete the entire course of treatment, even if symptoms improve or disappear. Stopping the medication early can lead to the infection returning and may contribute to the development of antibiotic-resistant bacteria. For streptococcal infections, treatment typically lasts at least 10 days. If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next dose.
Understanding Potential Side Effects and Precautions
Erythromycin ethylsuccinate can cause several side effects. Common gastrointestinal side effects include nausea, vomiting, abdominal pain, stomach cramping, diarrhea, and loss of appetite. Taking the medication with food can sometimes help reduce gastrointestinal discomfort.
Liver problems, including elevated liver enzymes and cholestatic hepatitis, have been reported, sometimes accompanied by jaundice (yellowing of the skin or eyes), dark urine, or pale stools. Erythromycin has also been associated with heart rhythm changes, specifically QT prolongation, which can lead to a fast, pounding, or irregular heartbeat, severe dizziness, or fainting. Individuals with existing heart conditions, electrolyte imbalances, or those taking other QT-prolonging medications may have a higher risk.
Other potential serious effects include severe allergic reactions, which can manifest as rash, itching, hives, swelling of the face, lips, mouth, tongue, or throat, and difficulty breathing. Clostridioides difficile-associated diarrhea (CDAD) can also occur, even months after treatment, characterized by watery or bloody stools, severe stomach cramps, and fever. Rare cases of hearing loss or ringing in the ears (tinnitus) have also been noted, particularly with higher doses or prolonged use.
Erythromycin ethylsuccinate requires precautions due to drug interactions. It can interact with numerous drugs, including certain cholesterol-lowering medications (statins), blood thinners, and drugs affecting heart rhythm. It inhibits the enzyme CYP3A4, which can increase blood levels of other medications. Always inform a healthcare provider about all current medications to prevent adverse interactions.
For pregnant individuals, discuss its use with a doctor. While generally compatible with breastfeeding, monitoring for infant side effects is advised. Rare reports link erythromycin use in infants to infantile hypertrophic pyloric stenosis, a condition causing severe vomiting.
When to Contact a Healthcare Professional
Seek immediate medical attention or call emergency services if symptoms of a severe allergic reaction occur, such as difficulty breathing, swelling of the face or throat, or hives. Signs of liver problems, including yellowing of the skin or eyes, dark urine, severe stomach pain, or persistent nausea and vomiting, should also prompt immediate medical consultation.
Contact a doctor without delay if you experience changes in heart rate or rhythm, such as a fast or skipping heartbeat, or if you feel faint or dizzy. Severe or persistent diarrhea, especially if it is watery or bloody and accompanied by stomach cramps or fever, requires immediate medical review, even if it occurs weeks or months after stopping the antibiotic. Any new or worsening symptoms, or if the infection does not improve after a few days of treatment, warrant a discussion with your healthcare provider.