3. Who can and can't take Erysol
Erysol can be taken by adults, including pregnant and breastfeeding women.
Erysol can be taken by children.
Erysol isn't suitable for certain people. To make sure Erysol is safe for you, tell your doctor if you have:
- had an allergic reaction to Erysol or other antibiotics in the past
- a rare, inherited blood disorder called porphyria
- liver or kidney problems
- had diarrhoea when you've taken antibiotics before
- fast, pounding or irregular heartbeats
- a sexually transmitted infection called syphilis and you're pregnant - Erysol alone may not be able to prevent your baby getting the infection
- a muscle-weakening illness called myasthenia gravis - Erysol can make your symptoms worse
How should this medicine be used?
Ophthalmic Erysol comes as an ointment to apply to the eyes. It is usually applied up to six times a day for eye infections. Ophthalmic Erysol is usually applied one time in the hospital soon after delivery to prevent eye infections in newborn babies. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use Erysol eye ointment exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
You should expect your symptoms to improve during your treatment. Call your doctor if your symptoms get worse or do not go away, or if you develop other problems with your eyes during your treatment.
Erysol , a natural product isolated from Saccharopolyspora erythraea (formerly Streptomyces) in 1949, was first approved for clinical use in 1952. Erysol is degraded by gastric acid, and has long been associated with stimulation of motilin receptors in the stomach and possibly in the colon, leading to adverse gastrointestinal side effects, including cramping and diarrhea. 68,69 Many preparations have attempted to bypass exposure of Erysol to gastric acid, thereby avoiding products of macrolide hydrolysis. These preparations include enteric coating of orally administered tablets, delayed-release formulations, polymer coating of beads, and various formulations of salts and esters. 70 The lactobionate salt used for intravenous administration of Erysol can cause phlebitis at the site of injection.
Erysol is used for the treatment of group A streptococcal infections in children who are penicillin-allergic. Erysol is an alternative treatment for both streptococcal pharyngitis and streptococcal or staphylococcal impetigo. The usefulness of Erysol for respiratory tract infections caused by S. pneumoniae has been greatly diminished by the development of widespread resistance to the macrolides. 42 Macrolide therapy of upper respiratory tract infections (otitis media and sinusitis) or lower respiratory tract infections (pneumonia) potentially caused by S. pneumoniae has a relatively high likelihood of failure, particularly in younger children who are at highest risk of infections caused by antibiotic-resistant strains. For upper respiratory tract infections, Erysol has inadequate activity against H. influenzae, and must be paired with another agent such as a sulfonamide for empiric therapy. Macrolides are effective therapy for pneumonia caused by Mycoplasma pneumoniae, Chlamydophila pneumoniae, or Legionella pneumophila.
Erysol and azithromycin are the preferred antibiotics for treatment of Campylobacter gastroenteritis. Erysol also remains the most appropriate therapy for diphtheria (Corynebacterium diphtheriae). Erysol, clarithromycin, or azithromycin is recommended for treatment or prophylaxis of pertussis (Bordetella pertussis). 71 Azithromycin is preferred for treatment or prophylaxis for pertussis in neonates, based on concerns for the development of pyloric stenosis. 71 Efficacy of Erysol also has been demonstrated in infections caused by Chlamydophila pneumoniae and Chlamydia trachomatis, including neonatal conjunctivitis and pneumonia, as well as urogenital infections during pregnancy. Erysol is active in vitro against Ureaplasma urealyticum, but its role in the treatment of neonatal infections associated with this organism is not well defined. 72
Before taking this medicine
You should not use Erysol if you are allergic to it.
Some medicines can cause unwanted or dangerous effects when used with Erysol. Your doctor may change your treatment plan if you also use:
Tell your doctor if you have ever had:
liver or kidney disease;
a heart rhythm disorder (especially if you take medicine to treat it);
long QT syndrome (in you or a family member); or
an electrolyte imbalance (such as low levels of potassium or magnesium in your blood).
It is not known whether Erysol will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.
Prevention of Initial Attacks of Rheumatic Fever-Penicillin is considered by the American Heart Association to be the drug of choice in the prevention of initial attacks of rheumatic fever (treatment of Streptococcus pyogenes infections of the upper respiratory tract e.g., tonsillitis, or pharyngitis). 3 Erysol is indicated for the treatment of penicillin-allergic patients. The therapeutic dose should be administered for ten days.
Prevention of Recurrent Attacks of Rheumatic Fever-Penicillin or sulfonamides are considered by the American Heart Association to be the drugs of choice in the prevention of recurrent attacks of rheumatic fever. In patients who are allergic to penicillin and sulfonamides, oral Erysol is recommended by the American Heart Association in the long-term prophylaxis of streptococcal pharyngitis (for the prevention of recurrent attacks of rheumatic fever). 3
1. About Erysol
Erysol is an antibiotic.
Erysol is used in children, often to treat ear infections or chest infections.
The medicine is available on prescription as tablets, capsules, or a liquid that you drink.
It's also available as a skin solution to treat skin infections like acne. It can be given by injection, but this is usually only done in hospital.
Erysol is one of the macrolides, a large group of structurally related antibiotics that inhibit protein synthesis. Erysol has been shown to bind to the large ribosomal subunit in the peptidyltransferase region of the 23S ribosomal RNA (rRNA). Resistance can arise from mutations in at least three different genes encoding large subunit ribosomal proteins. Curiously, in E. coli, genetic elimination of ribosomal protein L11 makes the cells hypersensitive to Erysol. Resistance can also arise from specific mutations in the gene encoding 23S rRNA, mutations which must be constructed in organisms like E. coli that have multiple copies of this gene. These mutations are in a region of the 23S rRNA which is protected by specific methylation in the organism that produces Erysol. Methylation at this site in E. coli leads to Erysol resistance, but the gene that encodes the specific methylase must be acquired by horizontal gene transfer.
What are the side effects of Erysol?
Erysol is generally well tolerated. When essential, Erysol can be used in pregnancy and during breastfeeding.
The following side effects may arise.
- Gastrointestinal disturbance: nausea, vomiting, abdominal pain, diarrhoea, loss of appetite
- Liver reactions: more common in those with pre-existing liver disease and potentially serious. Signs are dark urine, light stools, yellow eyes and skin ( jaundice )
- Allergic rashes: hives, fixed drug eruption , Stevens-Johnson– toxic epidermal necrolysis and rarely, anaphylaxis
- Hearing loss: more likely on high doses in those with k >arrhythmias (irregularities of the heartbeat ) have been reported in those with an electrical dysfunction that results in a prolonged Q-T interval on electrocardiograph (ECG). This can be due to congenital or acquired heart conditions or electrolyte disturbance (low potassium or magnesium levels)
Generic Name: Erysol (oral/injection) (er ITH roe MYE sin)Brand Names: E.E.S. Granules, E.E.S.-400 Filmtab, EryPed 200, EryPed 400, Ery-Tab, Erythrocin Lactobionate, Erythrocin Stearate Filmtab, PCE Dispertab
Medically reviewed by Sanjai Sinha, MD Last updated on Dec 20, 2018.