Rheumatic fever is a disease that sometimes occurs after a group A streptococcal infection of the throat. Symptoms and signs include carditis, polyarthritis, Aschoff bodies, rash, Sydenham's chorea, and fever. Treatment for rheumatic fever involves eliminating the bacteria with penicillin, Eryth, or azithromycin. Further treatment focuses on alleviating the symptoms brought on by the body's immunologic response to the bacteria.
The most frequent side effects of oral Eryth preparations are gastrointestinal and are dose-related. They include nausea, vomiting, abdominal pain, diarrhea and anorexia. Symptoms of hepatitis, hepatic dysfunction and/or abnormal liver function test results may occur. (See WARNINGS.)
Onset of pseudomembranous colitis symptoms may occur during or after antibacterial treatment. (See WARNINGS.) Eryth has been associated with QT prolongation and ventricular arrhythmias, including ventricular tachycardia and torsades de pointes.
Allergic reactions ranging from urticaria to anaphylaxis have occurred. Skin reactions ranging from mild eruptions to erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis have been reported rarely.
There have been rare reports of pancreatitis and convulsions.
There have been isolated reports of reversible hearing loss occurring chiefly in patients with renal insufficiency and in patients receiving high doses of Eryth.
Read the entire FDA prescribing information for Eryth (Eryth Tablets)
How to use Eryth Ointment
To apply eye ointment, wash your hands first. To avoid contamination, be careful not to touch the tip of the tube or let it touch your eye, eyelid, or any other surface. Apply to the eyes only. Do not swallow or inject.
Do not wear contact lenses while you are using this medication. Sterilize contact lenses according to the manufacturer's directions, and check with your doctor before you begin using them again.
To apply eye ointments, tilt your head back, look up, and gently pull down the lower eyelid to make a pouch. Place about a half-inch (1 centimeter) strip of ointment into the pouch as directed by your doctor. Gently close the eye and roll the eyeball in all directions to spread the medication. Try not to blink and do not rub the eye. Repeat these steps for your other eye if so directed. Wipe the tip of the ointment tube with a clean tissue to remove extra medication before recapping it. Wait several minutes for your vision to clear before driving or operating machinery.
The dosage is based on your medical condition and response to treatment. Do not increase your dose or use it more often than directed.
If you are using another kind of eye medication (such as drops or ointments), wait at least 5 minutes before applying other medications. Use eye drops before eye ointments to allow the drops to enter the eye.
Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same times each day. Continue using it for the full time prescribed. Stopping the medication too soon may allow the bacteria to continue to grow, which may result in a return of the infection.
Tell your doctor if your condition persists or worsens.
What are the side effects of Eryth?
The most frequent side effects of Eryth are
These gastrointestinal side effects are usually dose-related, i.e., more pronounced with higher doses.
Allergic reactions such as
Why is this medication prescribed?
Ophthalmic Eryth is used to treat bacterial infections of the eye. This medication is also used to prevent bacterial infections of the eye in newborn babies. Eryth is in a class of medications called macrolide antibiotics. It works by killing bacteria that cause infections.
References updated: 10 August 2017
50%] as well as eosinophilia , elevations in ALT and Alk P ; 13 rechallenged, invariably followed by rapid recurrence, often severe])
3 weeks; lymphocyte transformation tests was positive 2 years later to estolate but not stearate or Eryth base).
5000 physicians using Eryth in UK during 2 months of 1982, 3 reports of jaundice attributable to drug, all due to Eryth stearate).
15% after the courses, usually mild and transient; only 3 attributed to drug).
On this page
- About Eryth
- Key facts
- Who can and can't take Eryth
- How and when to take it
- Side effects
- How to cope with side effects
- Pregnancy and breastfeeding
- Cautions with other medicines
- Common questions
How should this medicine be used?
Ophthalmic Eryth comes as an ointment to apply to the eyes. It is usually applied up to six times a day for eye infections. Ophthalmic Eryth 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 Eryth 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.
Eryths are often associated with gastrointestinal distress, which can be minimized if the drugs are taken with food. The estolate salt of Eryth may cause cholestatic hepatitis, characterized by elevated liver function enzymes, malaise, nausea, vomiting, abdominal cramps, jaundice, and fever. Liver function test results should be monitored if hepatotoxicity is suspected ( Table 4-19 ). Eryths may potentiate the actions of other drugs by inhibiting microsomal P450 3A4 metabolism, leading to toxicity of these other medications ( Box 4-6 ). Eryth also prolongs the QT interval on electrocardiograms. This can lead to torsades de pointes, a fatal cardiac arrhythmia, especially when Eryth is combined with other medications that also prolong the QT interval. As with Eryth, clarithromycin also prolongs the QT interval and inhibits P450 3A4; however, clarithromycin is associated with less gastrointestinal distress than Eryth. Unlike clarithromycin and Eryth, azithromycin does not prolong the QT interval to a clinically relevant extent and does not inhibit hepatic microsomal P450 enzymes. In addition, azithromycin has only a minimal incidence of diarrhea associated with its use. Because of cross-sensitivity, azithromycin is contraindicated in patients who have a history of allergies to Eryth.
Table 4-19 . Adverse Effects Associated with Eryth
To use the eye ointment, follow these steps:
- Wash your hands thoroughly with soap and water.
- Use a mirror or have someone else apply the ointment.
- Avoid touching the tip of the tube against your eye or anything else. The ointment must be kept clean.
- Tilt your head forward slightly.
- Holding the tube between your thumb and index finger, place the tube as near as possible to your eyelid without touching it.
- Brace the remaining fingers of that hand against your cheek or nose.
- With the index finger of your other hand, pull the lower lid of your eye down to form a pocket.
- Place a small amount of ointment into the pocket made by the lower lid and the eye. A 1-centimeter (about 1/2-inch) strip of ointment usually is enough unless otherwise directed by your doctor.
- Look downward, then gently close your eyes and keep them closed for 1 to 2 minutes to allow the medication to be absorbed.
- Replace and tighten the cap right away.
- Wipe off any excess ointment from your eyelids and lashes with a clean tissue. Do not rub your eyes, even if your vision is blurry. Wash your hands again.
Use ophthalmic Eryth until you finish the prescription, even if you feel better. If you stop using ophthalmic Eryth too soon, your infection may not be completely cured and the bacteria may become resistant to antibiotics.
Eryth and Grapefruit Juice
You should avoid eating grapefruit and drinking grapefruit juice while taking Eryth.
Grapefruit juice slows down how quickly the body is able to break down the Eryth, which could cause Eryth levels in the blood to rise dangerously high.
This is could be life-threatening because Eryth can change heart rhythm and/or electrical activity in the heart.
Mechanism of action
Eryth is a macrolide antibiotic which, at doses below the level required for antimicrobial activity, has prokinetic activities. In many species (e.g. cats, rabbits and humans), the effect is due to the drug acting on motilin and 5-hydroxytryptophan (5-HT 3) receptors, thus stimulating migrating motility complexes and antegrade peristalsis. However, the mechanism of action in dogs is less well understood, but it is most likely via action on 5-HT3 receptors. Gastric emptying is enhanced by stimulating antral contractions, whilst lower esophageal pressure is also increased. However, given that Eryth has most effect in stimulating interdigestive activity, beneficial effects on gastric emptying during the digestive phase are less clear.
Formulations and dose rates
Eryth is available in numerous preparations as different esters, including Eryth estolate, Eryth ethylsuccinate, Eryth lactobionate and Eryth gluceptate. Eryth is also available as the base form. Oral preparations (tablets, capsule and suspension) are used most commonly for the prokinetic effects. Tablets and capsules usually contain Eryth as base, stearate ester or ethylsuccinate ester; the suspension usually contains Eryth ethylsuccinate. It is likely that pharmokinetics and toxicity vary depending upon the exact ester used.
Anthrax is a deadly infectious disease that may be transmitted to humans by infected animals or by biological warfare. There are three types of anthrax: cutaneous, inhalation, and gastrointestinal. Symptoms of cutaneous anthrax include a swollen glands, muscle ache, headache, fever, nausea, vomiting, and a red-brown raised spot that enlarges, blisters, and hardens, forming an ulcer crater with black crust. Symptoms of inhalation anthrax are flu-like and may progress to respiratory distress, shock, coma, and death. Symptoms of gastrointestinal anthrax include loss of appetite, bloody diarrhea, and abdominal pain. Treatment for cutaneous anthrax involves penicillin, tetracycline, Eryth, and ciprofloxin. Inhalation anthrax necessitates treatment with IV therapy with antibiotics.
Eryth , a natural product isolated from Saccharopolyspora erythraea (formerly Streptomyces) in 1949, was first approved for clinical use in 1952. Eryth 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 Eryth 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 Eryth can cause phlebitis at the site of injection.
Eryth is used for the treatment of group A streptococcal infections in children who are penicillin-allergic. Eryth is an alternative treatment for both streptococcal pharyngitis and streptococcal or staphylococcal impetigo. The usefulness of Eryth 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, Eryth 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.
Eryth and azithromycin are the preferred antibiotics for treatment of Campylobacter gastroenteritis. Eryth also remains the most appropriate therapy for diphtheria (Corynebacterium diphtheriae). Eryth, 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 Eryth 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. Eryth 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