Erythromycin
Macrolide antibacterial
For more detailed drug information, see Erythromycin in the AMH.
Dosage – Erythromycin
Bacterial infections
Length of course depends on the infection and its response to treatment.
Birth (at term) – 1 week, oral/IV infusion 10–12.5 mg/kg every 12 hours.
1 week – 1 month, oral/IV infusion 10–12.5 mg/kg every 8 hours.
1 month – 18 years, oral/IV infusion 10 mg/kg (up to 500 mg) every 6 hours. Usual adult dose is 250–500 mg every 6–8 hours (every 6 hours if given IV). Maximum 4 g daily in severe infections.
Oral doses <1 g daily can be given in 2 doses.
Pertussis treatment and prevention
Birth (at term) – 1 week, oral 10 mg/kg every 12 hours for 7 days.
1 week – 1 month, oral 10 mg/kg every 8 hours for 7 days.
1 month – 18 years, oral 10 mg/kg (maximum 250 mg) every 6 hours for 7 days.
Prevention of recurrent rheumatic fever
Use in cases of documented penicillin allergy.
1 month – 18 years, oral 250 mg every 12 hours. For duration of therapy, see Practice points.
Acne vulgaris
Oral, 250–500 mg twice daily.
Administration advice
Capsules should be taken on an empty stomach (but can be taken with food if there are GI adverse effects).
IV: give by slow infusion over at least 1 hour.
For information about parenteral administration, see the Royal Children's Hospital Paediatric Injectable Guidelines.
Off-label use
Product information does not include doses for prevention of pertussis.
Practice points
azithromycin or clarithromycin is preferred for pertussis treatment or prevention
doxycycline is preferred for moderate-to-severe acne in children aged >8 years
consider dosage adjustment in renal impairment
azithromycin and erythromycin are associated with infantile hypertrophic pyloric stenosis in neonates, especially those aged <2 weeks; the risk appears to be less with azithromycin
although erythromycin is used as a prokinetic agent, there is little evidence for its efficacy and bacterial resistance may develop
duration of antibacterial prophylaxis after acute rheumatic fever depends on risk of recurrence and the consequences for the patient; for further information, see the Australian guideline at rhdaustralia.org.au/arf-rhd-guidelines
Products
Search for Erythromycin on the PBS
cap, 250 mg (as erythromycin base) (enteric coated), 25, Erythromycin, PBS/PBS‑A[50]1
cap, 250 mg (as erythromycin base) (enteric coated), 25, Eryc
tab, 400 mg (erythromycin as ethyl succinate), 25, E-Mycin
oral liquid, 40 mg/mL (erythromycin as ethyl succinate) (powder), 100 mL, E-Mycin, PBS
oral liquid, 80 mg/mL (erythromycin as ethyl succinate) (powder), 100 mL, E-Mycin, PBS
inj, 1 g (erythromycin as lactobionate) (powder), 1, Erythrocin IVa
1 severe acne, see PBS
a generic brands available