Doses Of Erythromycin Research Articles

Cell death and DNA damage via ROS mechanisms after applied antibiotics and antioxidants doses in prostate hyperplasia primary cell cultures.

Tumor heterogeneity results in aggressive cancer phenotypes with acquired resistance. However, combining chemical treatment with adjuvant therapies that cause cellular structure and function perturbations may diminish the ability of cancer cells to resist at chemical treatment and lead to a less aggressive cancer phenotype. Applied treatments on prostate hyperplasia primary cell cultures exerted their antitumor activities through mechanisms including cell cycle blockage, oxidative stress, and cell death induction by flow cytometry methods. A 5.37 mM Chloramphenicol dose acts on prostate hyperplasia cells by increasing the pro-oxidant status, inducing apoptosis, autophagy, and DNA damage, but without ROS changes. Adding 6.30 mM vitamin C or 622 µM vitamin E as a supplement to 859.33 µM Chloramphenicol dose in prostate hyperplasia cells determines a significant increase of ROS level for a part of cells. However, other cells remain refractory to initial ROS, with significant changes in apoptosis, autophagy, and cell cycle arrest in G0/G1 or G2/M. When the dose of Chloramphenicol was increased to 5.37 mM for 6.30 mM of vitamin C, prostate hyperplasia cells reacted by ROS level drastically decreased, cell cycle arrest in G2/M, active apoptosis, and autophagy. The pro-oxidant action of 1.51 mM Erythromycin dose in prostate hyperplasia cell cultures induces changes in the apoptosis mechanisms and cell cycle arrest in G0/G1. Addition of 6.30 mM vitamin C to 1.51 mM Erythromycin dose in hyperplasia cell cultures, the pro-oxidant status determines diminished caspase 3/7 mechanism activation, but ROS level presents similar changes as Chloramphenicol dose and cell cycle arrest in G2/M. Flow cytometric analysis of cell death, oxidative stress, and cell cycle are recommended as laboratory techniques in therapeutic and diagnostic fields.

Effect of erythromycin residuals in food on the development of resistance in Streptococcus pneumoniae: an in vivo study in Galleria mellonella.

The use of antimicrobials to treat food animals may result in antimicrobial residues in foodstuffs of animal origin. The European Medicines Association (EMA) and World Health Organization (WHO) define safe antimicrobial concentrations in food based on acceptable daily intakes (ADIs). It is unknown if ADI doses of antimicrobials in food could influence the antimicrobial susceptibility of human-associated bacteria. This aim of this study was to evaluate if the consumption of ADI doses of erythromycin could select for erythromycin resistance in a Galleria mellonella model of Streptococcus pneumoniae infection. A chronic model of S. pneumoniae infection in G. mellonella larvae was used for the experiment. Inoculation of larvae with S. pneumoniae was followed by injections of erythromycin ADI doses (0.0875 and 0.012 μg/ml according to EMA and WHO, respectively). Isolation of S. pneumoniae colonies was then performed on selective agar plates. Minimum inhibitory concentrations (MICs) of resistant colonies were measured, and whole genome sequencing (WGS) was performed followed by variant calling to determine the genetic modifications. Exposure to single doses of both EMA and WHO ADI doses of erythromycin resulted in the emergence of erythromycin resistance in S. pneumoniae. Emergent resistance to erythromycin was associated with a mutation in rplA, which codes for the L1 ribosomal protein and has been linked to macrolide resistance in previous studies. In our in vivo model, even single doses of erythromycin that are classified as acceptable by the WHO and EMA induced significant increases in erythromycin MICs in S. pneumoniae. These results suggest the need to include the induction of antimicrobial resistance (AMR) as a significant criterion for determining ADIs.

Pharmacokinetics, PK/PD analysis and placental transfer of erythromycin administered to pregnant goats

The aims of the present study were i) to characterize the pharmacokinetic of erythromycin (ERY) after intravenous (IV) and intramuscular (IM) administration to pregnant goats, ii) to make a PK/PD analysis by Monte Carlo simulation from steady-state pharmacokinetic parameters of ERY by IV and IM routes considering sensitivity of coagulase negative staphylococci isolate of milk of goats, and iii) to determine the placental transfer of the drug after intravenous maternal administration. Six pregnant goats (87–89 days of pregnancy) received ERY by the IV (10 mg/kg) and the IM (15 mg/kg) routes of administration. Blood samples were collected at predetermined times. The same animals (145–147 days of pregnancy) received a 10 mg/kg dose of erythromycin by IV route of administration and underwent a cesarean surgery; blood venous fetal and maternal samples were collected. ERY concentrations were determined by microbiological assay. MIC of one hundred and twenty seven coagulase negative staphylococci isolated from goats was determined by broth macrodilution method. ERY showed a wide distribution with low serum concentrations after IV and a high bioavailability after IM administration. PK/PD analysis by Monte Carlo simulation indicates that 15 mg/kg every 8 h IM administration of ERY in pregnant goats may be adequate for sensitive microorganisms with MIC ≤ 0.25 µg/mL. However, 10 mg/kg IV showed that does not meet the objective even for strains with MIC ≤ 0.125 µg/mL. Placental transfer of ERY was low (Concentrationfetus/Concentrationmother = 0.10).

CASE REVIEW ON EFFECTS OF AZITHROMYCIN AND ERYTHROMYCIN ON LOWER RESPIRATORY INFECTION

Lower respiratory infections are generally caused by viral or bacterial agents. The majority of bronchitis and bronchiolitis cases are caused by viruses. Streptococcus pneumoniae is the most common bacterial agent in community-acquired pneumonias. An open, randomized study of the efficacy and safety of the prototype antibiotics azithromycin, and erythromycin in the treatment of lower respiratory infection were compared. Azithromycin and Erythromycin doses were administered and studied on various cases, in the treatment of lower respiratory infections, azithromycin seems to be as effective as erythromycin and better tolerated with lower side effects and effective therapeutic effects.

Uji Sensitivitas Erythromycin dan Chloramphenicol Terhadap Salmonella sp.

Salmonella sp. is a pathogenic microbe that causes digestive disorders that can cause death. One way to treat diseases caused by the bacteria Salmonella sp. is the use of antibiotic therapy. Salmonella sp. susceptible to antibiotic resistance due to improper use. The purpose of this study was to determine the susceptibility of Salmonella sp. Erythromycin and Chloramphenicol antibiotics. In this study, antibiotic sensitivity was tested using the Kirby-Bauer method (diffusion test) with a concentration of Erythromycin 250 mg/mL and antibiotics 500 mg/mL, Chloramphenicol antibiotics at concentrations of 250 mg/mL and 500 mg/mL. mL with 3 repetitions. The sample used in this study was a strain of Salmonella sp. suspended using Brain Heart Infusion Broth (BHIB) media and the antibiotic test was carried out using Mueller Hinton Agar (MHA) media. The greatest inhibition was seen in treatment with Chloramphenicol 500 mg/mL with an inhibition zone of 38.6 mm, followed by Chloramphenicol 250 mg/mL with an inhibition zone of 33.3 mm. The antibiotic Erythromycin 500 mg/ml had moderate inhibition against Salmonella sp. with an inhibition zone of 17.3 mm, while the antibiotic dose of Erythromycin 250 mg/ml produced a weak inhibitory effect on Salmonella sp. with a zone of inhibition of 12.5 mm.

Oncologic colorectal surgical site infection: oral or not oral antibiotic preparation, that is the question.

Surgical wound infection is the most frequent postoperative complication in abdominal surgery, especially at the colorectal level. The aim of this study is analysing the results of mechanical colon preparation combined with oral antibiotic versus mechanical colon preparation without antibiotic therapy in patients with colorectal cancer undergoing elective surgery. This retrospective cohort study had been developed from November 2017 to February 2020. We have included a total of 281 consecutive patients undergoing elective colon and rectal oncological surgeries by the same surgical group using laparoscopic and open approaches. Transanal minimally invasive surgery (TAMIS) and transanal total mesorectal excision (TaTME) approaches were excluded. Exposed patients undergoing colon and rectal cancer surgery received mechanical bowel preparation and oral antibiotics with three doses of neomycin 1g and erythromycin 500mg the day before surgery. The primary outcome was reduction in surgical wound infection rates before and after starting the oral antibiotic therapy from 17 to 6% (p < 0.05). As a secondary analysis, we evaluated the anastomotic dehiscence rate, corresponding with a decrease from 12 to 3% (p < 0.05). Mechanical bowel preparation combined with oral antibiotic therapy is still not unanimously carried out in all the medical hospitals. In this report, we show that mechanical bowel preparation in combination with oral antibiotic reduces the risk of surgical wound infection and anastomotic leakage in patients undergoing colon and rectal cancer surgery.

Assessment of toxicity and kinetic effects of erythromycin on activated sludge consortium by fast respirometry method

Background: The present study aimed to assess the acute impact of erythromycin (ERY) as an inhibitor on peptone mixture utilization of activated sludge (AS) consortium. Methods: For this purpose, the inhibition of oxygen consumption was used based on the ISO 8192:2007 procedure. In this method, the AS consortium (10-day age) was extracted from lab-scale membrane bioreactor, then, percentage inhibition for total, heterotrophic, and nitrifying microorganisms, in separate batch respirometric tests were calculated in the absence and presence of N-allylthiourea (ATU) as a specific Nitrification inhibitor. Results: The obtained data showed that the height of oxygen uptake rate (OUR) profiles and amount of oxygen consumption reduced with increasing ERY dose. The half-maximal effective concentration (EC50) of ERY for heterotrophic and nitrifier microorganisms were 269.4 and 1243.1 mg/L, respectively. In Run 1, the kinetic coefficients bH, fA,H, YH, and µH were calculated as 2.61 d-1, 0.44, 0.4945 mg VSS/mg COD, and 0.047 d-1, respectively. Also, for maximum ERY concentration (1000 mg/L), the kinetic coefficients bH., fA,H, YH, and µH were calculated as 2.27 d-1, 0.3, 0.4983 mg VSS/mg COD, and 0.0049 d-1, respectively. Conclusion: The findings showed that the inhibitory impact of ERY was observed as a decrease in the amount of oxygen consumption by OUR profiles in rapid respirometric method (ISO 8192), which offered a novel insight for the acute inhibitory impact of this antibiotic. Also, chemical oxygen demand (COD) as an overall substrate parameter is most helpful in interpreting the behavior and the metabolic functions of AS systems.

Optimal dose and duration of enteral erythromycin as a prokinetic: A surgical intensive care experience.

Background: Enteral feeding has various advantages over parenteral feeding in critically ill patients. Acutely ill patients are at risk of developing enteral feeding intolerance. Prokinetic medications improve gastrointestinal mobility and enteral feed migration and absorption. Among the available prokinetic agents, erythromycin is the most potent. Erythromycin is used in different dosages and durations with variable efficacy. Intravenous erythromycin has an early and high rate of tachyphylaxis; hence, enteral route is preferred. Recently, the combination of prokinetic medications has been increasingly used because they accelerate the prokinetic action and decrease the adverse effects.Aim: This study aimed to determine the optimal effective prokinetic dose and duration of administering enteral erythromycin in combination with metoclopramide in critically ill patients.Patients and methods: This study has a prospective observation design. After obtaining permission from the medical research center of the institution, all patients in the surgical and trauma intensive care unit having enteral feed intolerance and those who were already on metoclopramide for 24 hour (h) were enrolled in the study. Patients’ demographic data, diagnosis, surgical intervention, disease severity scores, erythromycin dose, duration of administration, any adverse effects, factors affecting erythromycin response, and outcome were recorded. All patients received 125 mg syrup erythromycin twice daily through a nasogastric tube (NGT). The NGT was clamped for 2 h, and half amount of previous enteral feeds was resumed. If the patient did not tolerate the feeds, the erythromycin dose was increased every 24 h in the increment of 250, 500, and 1000 mg (Figure 1). Statistical significance was considered at P < 0.05. A total of 313 patients were enrolled in the study. Majority of the patients were male, and the mean age was 45 years.Results: Majority (48.2%) of the patients (96) with feed intolerance were post laparotomy. Ninety percent (284) of the patients responded to prokinetic erythromycin therapy, and 54% received lower dose (125 mg twice daily). In addition, 14% had diarrhea, and none of these patients tested positive for Clostridium difficile toxin or multidrug resistance bacteria. The mean duration of erythromycin therapy was 4.98 days. The most effective prokinetic dose of erythromycin was 125 mg twice daily (P = 0.001). Erythromycin was significantly effective in patients with multiple organ dysfunction and shock (P = 0.001). Patients with high disease severity index and multiple organ dysfunction had significantly higher mortality (p < 0.05). Patients not responding to erythromycin therapy also had a significant higher mortality (p = 0.001).Conclusion: Post-laparotomy patients had high enteral feed intolerance. Enteral erythromycin in combination with metoclopramide was effective in low dose and was required for short duration. Patients who did not tolerate feeds despite increasing dose of erythromycin had higher mortality.

The Effect of Acute Erythromycin Exposure on the Swimming Ability of Zebrafish (Danio rerio) and Medaka (Oryzias latipes).

Erythromycin is a widely used antibiotic, and erythromycin contamination may pose a threat to aquatic organisms. However, little is known about the adverse effects of erythromycin on swimming ability. To quantify erythromycin-induced damage to fish swimming ability, Oryzias latipes and Danio rerio were acutely exposed to erythromycin. The swimming ability of the experimental fish was measured after exposure to varying doses of erythromycin (2 µg/L, 20 µg/L, 200 µg/L, and 2 mg/L) for 96 h. Burst speed (Uburst) and critical swimming speed (Ucrit) of experimental fish significantly decreased. In addition, gene expression analysis of O. latipes and D. rerio under erythromycin treatment (2 mg/L) showed that the expression of genes related to energy metabolism in the muscle was significantly reduced in both species of fish. However, the gene expression pattern in the head of the two species was differentially impacted; D. rerio showed endocrine disruption, while phototransduction was impacted in O. latipes. The results of our study may be used as a reference to control erythromycin pollution in natural rivers.

Effect of Cardisoma guanhumi (Land Crab) Extract on Haematology and Lungs Histology in Swiss Mice Infected with Bordetella pertussis

Pertussis is an acute human respiratory tract disease caused by Bordetella pertussis, a known international pathogen that affects infants, children and adults. This study is aimed at investigating the changes in haematological parameters and histopathological changes of the lungs connected with Bordetella pertussis infection in swiss mice and to evaluate the potential of Cardisoma guanhumi extract to reverse these adverse changes about erythromycin treatment. The animals were divided into five groups: Group 1 was normal to control, group 2 was infected with Bordetella pertussis without treatment (negative control), group 3 and 4 were Bordetella pertussis infected and treated with 300 mg/kg and 600 mg/kg of the extract respectively and group 5 were infected and treated with 4000 mg/70 kg of erythromycin in divided doses. The animals were inoculated with a single infectious dose of Bordetella pertussis bacteria and were consequently treated with the graded doses of the extract and erythromycin for eighteen days after the animals were confirmed infected. The mice were humanely sacrificed using diethyl ether anaesthesia and blood samples were taken for liver function investigation and liver tissue harvested and processed for histological examination. The result showed that Cardisoma guanhumi extract reversed the changes in the haematological parameters and pathological changes in the lungs of mice infected with Bordetella pertussis in a dose and time-dependent manner which suggests prophylactic and curative potentials of Cardisoma guanhumi extract against B. pertussis.

Effect of Goniopsis Pelli (Marine Crab) Extract on Hematology and Lungs Histology in Swiss Mice Infected with Bordetella Pertussis

Pertussis is a global endemic infectious disease with outbreaks every 3–5 years is associated with lungs inflammations and hematological alterations. This study is aimed at investigating the changes in hematological parameters and histopathological changes of the lungs associated with Bordetella pertussis infection in swiss mice and to evaluate the ability of Goniopsis pelli extract to reverse these adverse changes in relation to erythromycin treatment. The animals were divided into five groups: group 1 was normal control, group 2 was infected with Bordetella pertussis without treatment (negative control), group 3 and 4 were Bordetella pertussis infected and treated with 300mg/kg and 600mg/kg of the extract respectively and group 5 was infected and treated with 4000mg/70kg of erythromycin in divided doses. The animals were inoculated with a single infective dose of Bordetella pertussis bacteria and were consequently treated with the graded doses of the extract and erythromycin for a period of eighteen days, after the animals were confirmed infected. The mice were humanely sacrificed using diethyl ether anesthesia and blood samples taken for hematological investigation and lungs tissue harvested and processed for histological examination. The result shows that Goniopsis pelli extract reversed the changes in the hematological parameters and pathological changes in the lungs of mice induced by Bordetella pertussis infection of in a dose and time dependent manner which suggests that prophylactic and curative potentials of Goniopsis pelli extract against B. pertussis.

Effect of Cardisoma guanhumi (land crab) extract on liver function and liver histology of Swiss mice infected with Bordetella pertussis

Pertussis also known as whooping cough is an acute human respiratory tract disease caused by Bordetella pertussis that is known to be associated with liver pathology. The aim of this study was to investigate the effects of Bordetella pertussis infection on the liver function and histology of Swiss mice and to evaluate the mitigating effects of Cardisoma guanhumi extract on these changes in comparison to erythromycin treatment. The animals were divided into five groups: group 1 was normal control; group 2 was infected with Bordetella pertussis without treatment (negative control); groups 3 and 4 were Bordetella pertussis infected and treated with 300mg/kg and 600mg/kg of Cardisoma guanhumi extract, respectively; and group 5 was infected and treated with 4000mg/70kg of erythromycin in divided doses. The animals were inoculated with a single infective dose of Bordetella pertussis and were consequently treated with the graded doses of the extract and erythromycin for a period of eighteen days, after the animals were confirmed infected. The mice were humanely sacrificed using diethyl ether anesthesia and blood samples taken for evaluation of liver function and liver tissue harvested and processed for histological examination. The results showed that Cardisoma guanhumi extract reversed the pathological changes in the liver of mice infected with Bordetella pertussis in a dose- and time-dependent manner, suggesting prophylactic and curative potentials of Cardisoma guanhumi extract against B. pertussis.

Evaluation of Leukocyte Mobilization and Platelet Aggregatory Effects of Ciprofloxacin, Lincomycin and Erythromycin in Wistar Albino Rats

This study evaluated leucocyte mobilization and platelet aggregation effects of ciprofloxacin, lincomycin and Erythromycin in Wistar albino rats. Thirty-three female Wistar albino rats weighing 130-160 g and three male Wistar albino rats weighing 188-194 g, fed commercial growers’ mash and clean tap water were used. In leukocytes assay, thirty-three adult female Wistar rats were assigned into five treatments, eleven groups of three rats per group. First three groups were treated 10 mg kg-1, 20 mg kg-1 and 40 mg kg-1 of ciprofloxacin, next three groups same doses of lincomycin, next three groups same doses of Erythromycin, the tenth group received Indomethacin 5 mg kg-1 (reference drug), the last group 5 mg kg-1 normal saline. Assay on platelet aggregator activity involved collection of blood samples (10 ml each, 1% EDTA, centrifuged at 3000 rpm for 10 minutes), test drugs dissolved in 1 mg/ml distilled water and Indomethacin (the reference drug). The three antibiotics significantly reduced leucocyte mobilization into the affected tissue. They all had their maximum inhibitory effects at the highest dose (40 mg kg-1) compared with indomethacin. Erythromycin 40 mg kg-1 showed the highest inhibitory effect on leucocyte migration. Whereas ciprofloxacin and erythromycin had stepwise increase in absorbance from time 0 secs through to time 120 secs, lincomycin showed a sharp decrease in the absorbance at around 30 seconds followed by a continuous increase up to 120 seconds. The testing drugs prevented leukocyte mobilization also had stepwise increase in absorbance from time 0 secs through to time 120 secs in platelet aggregatory activity assay to some extent.

Evaluating the Effect of the Intermediate-Dose Oral Erythromycin on the Treatment of Feeding Intolerance in Premature Neonates: A Randomized Clinical Trial Study

Background: Gastrointestinal (GI) dysmotility is a common problem among preterm neonates with very-low-birth-weight and is manifested as feeding intolerance, and in this situation, total parenteral nutrition (TPN) is needed for several complications. Erythromycin is a prokinetic antibiotic that neonatologists widely prescribe for the treatment of GI dysmotility in high and low doses. Objectives: This study aimed to evaluate the effects of an intermediate dose of Erythromycin in the treatment of feeding intolerance in preterm neonates. Methods: This study is a randomized clinical trial on preterm neonates admitted in two university-affiliated hospitals in Isfahan, Iran, during 2016 - 2017. Feeding is started for all neonates with 20 mL/kg/day doses and if they tolerate it, 20 mL/kg/day is added daily to receive toreach 150 mLcc/kg/day. The infants were divided into two groups, which received either Erythromycin (5 mg/kg/dose every 6 hours) or placebo for eight days. These outcomes were evaluated: time duration to reach 75, 110, and 150 mL/kg/day feeding volume, lavage count after the intervention, time duration of oxygen dependency and hospitalization, the incidence of necrotizing enterocolitis, intraventricular hemorrhage, patent ductus arteriosus, chronic lung disease, cholestatic icterus, sepsis, and hypertrophic pyloric stenosis. Results: Sixty-four neonates (female 38 (59.3%) and male 26 (40.6%)) with the mean gestational age 30.10 ± 2.49 weeks were evaluated. The mean time duration to reach 75, 110, and 150 mL/kg/day feeding volume was significantly lower in the Erythromycin group (4.19 vs. 6.84 days, P < 0.001, 6.35 vs. 9.08 days, P < 0.001 and 9 vs. 11.46 days, P < 0.001 in the Erythromycin vs. placebo groups, respectively). Also the number of lavages were significantly lower in the Erythromycin group (0.35 ± 0.56 vs. 3.03 ± 3.08 in the Eerythromycin and placebo groups; P < 0.001). Conclusions: Intermediate dose of Erythromycin can reduce the time duration to reach full feeding volume and is safe for preterm neonates.

Evaluation of anti-inflammatory and analgesic activities of selected antibiotics in Wistar Albino rats

Anti-inflammatory, analgesic, and leukocyte mobilization activities of ciprofloxacin, lincomycin, and erythromycin were evaluated in this study. The study involved two sets of thirty-three adult female Wistar rats assigned into five treatments, grouped into eleven of three rats per group. For agar-induced paw edema, the first three groups were treated 10 mg/kg, 20 mg/kg, and 40 mg/kg of ciprofloxacin, next three groups same doses of lincomycin, next three groups same doses of erythromycin, the tenth group received the reference drug, indomethacin 5 mg/kg while the last group 5 mg/kg normal saline. The analgesic activities group treatments were first nine groups received the three antibiotics in the same trend but at different doses of 50 mg/kg, 100 mg/kg, and 200 mg/kg. The tenth group received acetylsalicylic acid (Asp 100 mg/kg) while the last group received normal saline (5 ml/kg). Erythromycin had minimal effect on rat paw edema with non-significant inhibition. Ciprofloxacin and lincomycin suppressed agar-induced rat paw edema both at early and later phases of edema. Remarkably, lincomycin was most effective. Whereas lincomycin suppressed the action of phospholipase A2 with increasing concentration, erythromycin and ciprofloxacin best inhibited the enzyme at their lowest concentrations. Whereas ciprofloxacin had an analgesic effect, lincomycin and erythromycin did not exhibit analgesic effects. The three antibiotics significantly reduced leucocyte mobilization into the affected tissue especially at the highest dose (40 mg kg−1). Conclusively, based on our findings, we suggest that these antibiotics can be considered for use as anti-inflammatory and analgesic drugs. The testing drugs prevented leukocyte mobilization.

Azithromycin Induces Migrating Motor Complexes in Pediatric Patients Undergoing Antroduodenal Motility Studies.

Erythromycin (ERY) is used in the treatment of gastroparesis; however, this medication is associated with serious side effects, such as cardiac arrhythmias and consequent cardiorespiratory arrest. Azithromycin (AZM) has been suggested as an alternative to ERY as a result of its improved safety profile. Intravenous ERY (1 mg/kg) is administered during antroduodenal motility studies to induce migrating motor complexes (MMCs), the presence or absence of which helps diagnose motility disorders like gastroparesis and gastrointestinal dysmotility. However, there are no pediatric studies comparing the effects of AZM and ERY on antroduodenal pressure profiles. The goal of this study is to determine if AZM is comparable in inducing MMCs in pediatric patients undergoing antroduodenal motility studies. We performed a retrospective chart analysis of gastric and small bowel manometric data in 2 adolescent patients, both age 15 years, who were given AZM (1 mg/kg) during antroduodenal motility studies. The pressure profiles obtained during motility studies were compared to those of patients of similar age and symptomology who were given the standard intravenous ERY dose during motility studies. We then compared the total duration of effect, mean amplitude of contractions, number of cycles per minute, and duration of highest antral and duodenal contractions. Intravenous AZM induces migrating motor contractions in the stomach followed by contractions in the small intestine. The mean amplitude of the stomach contractions was 259 mm Hg in patients who received AZM vs 241 mm Hg in patients who received ERY. The mean amplitude of small intestinal MMCs was 68 mm Hg in patients who received AZI and 72 mm Hg in patients who received ERY. Additionally, the frequency and duration of stomach and small intestinal contractions were also similar in the 2 groups. Intravenous AZM has similar prokinetic effects to intravenous ERY. Our study suggests that AZM is a suitable alternative to ERY in inducing MMCs without the concerning side effects related to ERY and may potentially be used in the management of gastroparesis and other small bowel motility disorders. However, larger prospective studies are required to better understand the long-term efficacy of AZM.

Cost Analysis of Azithromycin versus Erythromycin in Pregnancies Complicated by Preterm Premature Rupture of Membranes.

To quantify the potential cost savings if azithromycin is substituted for erythromycin in women with preterm premature rupture of membranes (PPROM). Secondary analysis of a multicentered study investigating magnesium sulfate for the prevention of cerebral palsy in premature infants. All patients with PPROM who received antibiotics for prophylaxis were included in the analysis. The number of expected doses each patient would have received was calculated for erythromycin, multidose azithromycin, and single-dose azithromycin regimens accounting for latency from PPROM to delivery. The wholesale acquisition cost was used to calculate the expected cost of each regimen. There were 981 PPROM patients who received a penicillin class antibiotic and erythromycin. Patients would have received 7,528 intravenous doses and 10,194 oral doses of erythromycin at a combined cost of $357,169. In comparison, patients would have received 6,422 and 3,942 doses at a cost of $15,669 and $9,574 for the multidose and single-dose azithromycin regimens respectively, which represents a more than 95% cost reduction for either regimen compared with erythromycin. The use of azithromycin substituted for erythromycin in the standard antibiotic regimen of women with PPROM represents a potential for substantial cost reduction.

Pharmacological Neuroprotection in Cardiac Surgery: Effectiveness of Pharmacologic-Preconditioning with Erythromycin.

Regardless of the degree of advances in neuroprotective strategies, and despite the technological progress in neuromonitoring, brain injury still remains the "Achilles' heel" in cardiac surgery. A large number of pharmacological and non-pharmacological therapeutic interventions have been investigated during the last two decades. Recently, both theoretical and experimental findings suggest benefits of pharmacological cerebral protection, although, there is no conclusive evidence of clinical superiority of specific agents that have been applied as neuroprotectants, in human randomized controlled trials. Pre-ischemic conditioning has also been used in an attempt to reduce the incidence of brain injury following cardiac surgery. In light of previous evidence showing that pharmacologic preconditioning with a single dose of erythromycin induces tolerance against transient global cerebral ischemia in rats, we examined whether erythromycin would reduce the number of apoptotic neurons in the neocortex in our acute porcine model of hypothermic circulatory arrest (HCA). Pre-ischemic conditioning with a single dose of the antibiotic erythromycin, applied 12 h before HCA, significantly reduced neuronal injury in the neocortex of the porcine brain, suggesting that cerebral protection may be achieved with erythromycin pharmacological preconditioning in cardiac surgery on an experimental basis. Since erythromycin has been effectively used in clinical practice with few side effects, these findings suggest that it could be a promising candidate for potential clinical neuroprotective strategy.

Characterization of bacterial diversity in soil contaminated with the macrolide antibiotic erythromycin and/or inoculated with a multidrug-resistant Raoultella sp. strain using the PCR-DGGE approach

Antibiotics and microorganisms that are resistant to these drugs enter the soil via the use of sewage sludge, effluents and manure from antibiotic-treated animals and may cause significant changes in the diversity of microorganisms. The goal of this research was to evaluate the changes in the genetic diversity of a bacterial community in the soil after the addition of two different doses of erythromycin (EM) (1 and 10 mg/kg soil) and/or a multidrug-resistant Raoultella sp. strain (1.6 × 107 cells/g soil). The Raoultella sp. strain was isolated from raw sewage and expressed a resistance to erythromycin, clindamycin, tetracycline and vancomycin. A denaturing gradient gel electrophoresis (DGGE) analysis revealed that the pattern for the EM10-treated soil was significantly different from the one that was obtained for the control soil, which was also shown by a significant decrease in the values of the DGGE indices (diversity and richness) on days 15, 30 and 60. In turn, a lower dose of EM and/or the introduced bacterial strain had no effect on the diversity and richness of the dominant member of the soil bacterial community. A multivariate analysis demonstrated that the DGGE indices were significantly influenced by the dose of EM and the duration of the incubation. A principal component analysis (PCA) also revealed that EM and/or the bacterial strain significantly changed the microbial community structure on days 15, 30 and 60, which was also demonstrated by analyses of the PC scores using the MANOVA analysis for all of the sampling days and each day. Although the negative effect of a higher dose of EM on the biodiversity of soil bacteria (less number of genus) was transient, the application of EM into soil may temporarily pose a potential risk for soil functioning.

Role of oral erythromycin for feed intolerance in neonates - A randomized controlled trial

Objective: The objective of this study was to compare the effect of high and low dose of erythromycin with placebo and to determine the efficacy and safety of oral erythromycin for feed intolerance in neonates admitted to the neonatal intensive care unit. Methodology: The study was a double-blind, randomized, and placebo-controlled trial. Term and preterm babies having feed intolerance were included in the study, and babies with congenital malformations, necrotizing enterocolitis, and sepsis were excluded from the study. After parental consent, the subjects were randomized into Groups 1, 2, or 3 to receive low-dose (3 mg/kg/dose) or high-dose (10 mg/kg/dose) oral erythromycin estolate or the placebo (equal volume of 5% dextrose). Feeding of all the study neonates was managed as per the unit protocol and babies were monitored for the complications. The primary outcome was the time to reach full feeds of 150 ml/kg/day, without significant gastric residuals. Results: Of 58 eligible babies, 84.5% were preterm babies. The median time for reaching full feeds with placebo was 6 days with interquartile range 3