INDICATIONS AND USAGE
To reduce the development of drug-resistant bacteria and maintain
the effectiveness of Erythromycin Delayed-release Capsules and other
antibacterial drugs, Erythromycin Delayed-release Capsules should be used only
to treat or prevent infections that are proven or strongly suspected to be
caused by susceptible bacteria. When culture and susceptibility information are
available, they should be considered in selecting or modifying antibacterial
therapy. In the absence of such data, local epidemiology and susceptibility
patterns may contribute to the empiric selection of therapy.
Erythromycin is indicated in the treatment of infections caused by
susceptible strains of the designated microorganisms in the diseases listed
below:
Upper respiratory tract infections of mild to moderate degree caused by Streptococcus pyogenes, Streptococcus
pneumoniae, or Haemophilus influenzae (when
used concomitantly with adequate doses of sulfonamides, since many strains of
H. influenzae are not susceptible to the erythromycin
concentrations ordinarily achieved). (See appropriate sulfonamide labeling for
prescribing information.)
Lower-respiratory tract infections of mild to moderate severity caused by
Streptococcus pneumoniae or Streptococcus pyogenes.
Listeriosis caused by Listeria monocytogenes.
Pertussis (whooping cough) caused by Bordetella
pertussis. Erythromycin is effective in eliminating the organism from the
nasopharynx of infected individuals rendering them noninfectious. Some clinical
studies suggest that erythromycin may be helpful in the prophylaxis of pertussis
in exposed susceptible individuals.
Respiratory tract infections due to Mycoplasma
pneumoniae.
Skin and skin structure infections of mild to moderate severity caused by
Streptococcus pyogenes or Staphylococcus aureus (resistant staphylococci may emerge
during treatment).
Diphtheria: Infections due to Corynebacterium
diphtheria, as an adjunct to antitoxin, to prevent establishment of
carriers and to eradicate the organism in carriers.
Erythrasma: In the treatment of infections due to Corynebacterium minutissimum.
Syphilis caused by Treponema pallidum:
Erythromycin is an alternate choice of treatment for primary syphilis in
penicillin-allergic patients. In treatment of primary syphilis, spinal fluid
examinations should be done before treatment and as part of follow-up after
therapy.
Intestinal amebiasis caused by Entamoeba
histolytica (oral erythromycins only). Extraenteric amebiasis requires
treatment with other agents.
Acute pelvic inflammatory disease caused by Neisseria
gonorrhoeae: Erythromycin lactobionate for injection, USP followed by
erythromycin base orally as an alternative drug in treatment of acute pelvic
inflammatory disease caused by N. gonorrhoeae in
female patients with a history of sensitivity to penicillin. Patients should
have a serologic test for syphilis before receiving erythromycin as treatment of
gonorrhea and a follow-up serologic test for syphilis after 3 months.
Erythromycins are indicated for the treatment of the following infections
caused by Chlamydia trachomatis: conjunctivitis of
the newborn, pneumonia of infancy, and urogenital infections during pregnancy.
When tetracyclines are contraindicated or not tolerated, erythromycin is
indicated for the treatment of uncomplicated urethral, endocervical, or rectal
infections in adults due to Chlamydia
trachomatis.
When tetracyclines are contraindicated or not tolerated, erythromycin is
indicated for the treatment of nongonococcal urethritis caused by Ureaplasma urealyticum.
Legionnaires' Disease caused by Legionella
pneumophila. Although no controlled clinical efficacy studies have been
conducted, in vitro and limited preliminary clinical
data suggest that erythromycin may be effective in treating Legionnaires'
Disease.
Prophylaxis
Prevention of Initial Attacks of Rheumatic FeverPenicillin 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). Erythromycin is
indicated for the treatment of penicillin-allergic patients.3 The therapeutic dose should be administered for 10
days.
Prevention of Recurrent Attacks of Rheumatic FeverPenicillin 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 erythromycin 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