Dosage Of Erythromycin Research Articles

The effectiveness of erythromycin in reducing stent-related tissue hyperplasia: an experimental study with a rat esophageal model

Erythromycin is not only a potent antibiotic; it also has effects of reduction of inflammation and suppression of protein synthesis. To evaluate the impact of erythromycin on tissue hyperplasia after stent placement in a rat esophageal model. A total of 21 rats were included. After placement of self-expanding stents in the mid esophagus, the rats were divided into two experimental groups and one control group. The rats in the experimental groups received daily intraperitoneal injections of erythromycin for 5 weeks; 4 mg/kg (group A, n = 7) and 8 mg/kg (group B, n = 7). Those in the control group (n = 7) received 1 mL of saline intraperitoneally. After sacrifice, histologic analysis was done for thickness of the papillary projection, granulation tissue area, percentage of granulation tissue area, and degree of inflammatory cell infiltration. The statistical significance of differences between groups was assessed by Mann-Whitney U test. Tissue hyperplasia as reflected in thickness of papillary projection, granulation tissue area, and percentage of granulation tissue area, was higher in the control group than in the experimental groups, although there was no statistical significance (P = 1.00, 0.332, and 0.263, respectively). However, degree of inflammatory cell infiltration was significantly lower in the experimental groups than the control group (P = 0.025), and the higher dosage of erythromycin reduced inflammatory cell infiltration significantly (P = 0.037). Intraperitoneal administration of erythromycin is very effective in reducing inflammation after stent placement in a rat esophageal model but has no significant effect on granulation tissue formation.

Correction: A case of severe, refractory diabetic gastroparesis managed by prolonged use of aprepitant

Chong, K. & Dhatariya, K. A case of severe, refractory diabetic gastroparesis managed by prolonged use of aprepitant. Nat. Rev. Endocrinol. 5, 285–288 (2009). In the May issue of Nature Reviews Endocrinology, the dosage of erythromycin in the first sentence of the fourth paragraph of The Case section should have read “low-dose erythromycin (0.

Validation of Erythromycin Microbiological Assay Using an Alternative Experimental Design

The agar diffusion method, widely used in antibiotic dosage, relates the diameter of the inhibition zone to the dose of the substance assayed. An experimental plan is proposed that may provide better results and an indication of the assay validity. The symmetric or balanced assays (2 x 2) as well as those with interpolation in standard curve (5 x 1) are the main designs used in the dosage of antibiotics. This study proposes an alternative experimental design for erythromycin microbiological assay with the evaluation of the validation parameters of the method referring to linearity, precision, and accuracy. The design proposed (3 x 1) uses 3 doses of standard and 1 dose of sample applied in a unique plate, aggregating the characteristics of the 2 x 2 and 5 x 1 assays. The method was validated for erythromycin microbiological assay through agar diffusion, revealing its adequacy to linearity, precision, and accuracy standards. Likewise, the statistical methods used demonstrated their accordance with the method concerning the parameters evaluated. The 3 x 1 design proved to be adequate for the dosage of erythromycin and thus a good alternative for erythromycin assay.

Erythromycin-Induced Ototoxicity: Case Report

Objective: To report a case of erythromycin-induced ototoxicity and to discuss the occurrence of this event. Case Summary: A 26-year-old woman was admitted to the medical intensive care unit with a two-day history of progressive shortness of breath, high-grade fever, cough, and pleuritic chest pain. Arterial blood gases on room air showed severe hypoxemia, and a chest X-ray revealed right lower-lobe infiltrates. Provisional diagnosis was atypical pneumonia, for which erythromycin lactobionate 1 g q6h iv was administered. All other chronic medications were maintained at the same dosage and frequency. All laboratory work remained stable. After 36 hours, the patient developed sensorineural hearing loss. Erythromycin was stopped immediately. After 24 hours, there was subjective improvement of hearing, with complete return to pretreatment levels in 72 hours. Discussion: A review of the literature showed only 40 reported cases of reversible ototoxicity, mainly with high dosages of erythromycin (4 g/d). Conclusions: High-dose erythromycin therapy can cause reversible sensorineural hearing impairment. Treatment with erythromycin 4 g/d should be reserved for immunosuppressed patients with Legionnaires' disease and patients with Legionella endocarditis. Patients should have a baseline audiogram and regular monitoring for subjective evidence of sensorineural hearing loss, and the drug should be discontinued if ototoxicity is suspected.

Treatment of Legionnaires?? Disease

Legionnaires' disease is a relatively common cause of community-acquired pneumonia and of some outbreaks of hospital-acquired pneumonia. Moreover, Legionella pneumophila is frequently involved in the aetiology of the subset of pneumonias that is characterised by severe clinical course and high mortality. No sure clinical, radiographical or analytical features are useful in differentiating Legionella infection from other aetiologies of pneumonia. On the basis of these data, a rational initial therapeutic approach to community-acquired pneumonia, as well as to nosocomial pneumonia in certain circumstances, has to include an antimicrobial agent that is clinically effective against Legionella spp. Clinical studies have provided evidence that erythromycin is the first-line treatment. An intravenous dosage of 1g every 6 hours as initial therapy will be effective in most cases. Parenteral treatment may be switched to oral administration only after clinical response is observed. In vitro susceptibilities and preliminary experimental and clinical results suggest that clarithromycin will most likely become the preferred treatment once an intravenous preparation is available worldwide. However, orally administered clarithromycin at the dosage of 500 mg every 12 hours may be recommended in those developing countries in which health systems cannot afford the costs of intravenous therapy. In the case of clinically severe illness or in seriously immunosuppressed hosts with confirmed legionellosis, a combined therapeutic approach is warranted. Rifampicin 600 mg every 12 hours intravenously or orally has to be added to the usual dosage of erythromycin. Other alternative therapies, but with less distinct clinical efficacy, that can be combined with erythromycin are doxycycline 100 mg every 12 hours intravenously or orally, and intravenous ciprofloxacin 200 mg every 6 hours.

Treatment of Anaerobic Pleuropulmonary and Soft-Tissue Infections-Reply

In Reply.— We want to thank Drs Covelli and Carpenter for their letter but believe that the significance of their experience in two patients is uncertain because of the scarcity of data. Unfortunately, we are not given any microbiological data, other than Gram's stains of sputum, on their cases. There are no cultural data with regard to aerobic or anaerobic organisms, either pretreatment or after failure, and consequently, no antimicrobial susceptibility data. Drs Covelli and Carpenter did not state what dosage of erythromycin was used, whether the patients were compliant in taking the medication, and what, if any, adjunctive therapeutic measures were used. It is well known that proper pulmonary toilet, including postural drainage, is an important component of therapy for lung abscess. Progression to cavitation (case 1) does not necessarily imply treatment failure. As regards duration of therapy, their patients had courses of 14 days (case 1) and