Erythromycin allergy

Broad intravenous antibiotic coverage for the encapsulated organisms can include ceftriaxone or cefotaxime. For patients with true cephalosporin allergy, clindamycin may be used. If staphylococcal infection is suspected owing to previous history or the patient appears acutely ill, vancomycin should be initiated. Macrolide antibiotics, such as erythromycin and azithromycin, may be initiated if Mycoplasma pneumonia is suspected. While the patient is receiving broad-spectrum antibiotics, their regular use of penicillin for prophylaxis can be suspended. Fever should be controlled with acetaminophen or ibuprofen. Because of the risk of dehydration during infection with fever, increased fluid may be needed.6,27... 

Other FDA-approved antibiotics for ABRS not included in the Sinus and Allergy Health Partnership or AAP guidelines cefaclor, cefprozil, cefixime, ciprofloxacin, erythromycin, loracarbef. cMaximum dose not to exceed adult dose. 

Because GAS historically has been the primary causative organism, penicillin has been the mainstay of therapy. O However, the incidence ofS. aureus impetigo is increasing, so oral penicillinase-stable penicillins or first-generation cephalosporins are now preferred.3 Erythromycin is an alternative choice when penicillin allergy is a concern. Topical mupirocin may be used alone when there are few lesions.3... 

Ms. Jones takes fexofenadine 60 mg twice a day for seasonal allergies. She comes to her physician with a sinus infection and receives a prescription for erythromycin, a drug known to inhibit CYP3A4. As a result of this drug interaction, you would expect Ms. Jones to... 

Adverse reactions. Erythromycin is remarkably nontoxic, but the estolate can cause cholestatic hepatitis with abdominal pain and fever which may be confused with viral hepatitis, acute cholecystitis or acute pancreatitis. This is probably an allergy, and recovery is usual but the estolate should not be given to a patient with liver disease. Other allergies are rare. Gastrointestinal disturbances occur frequently (up to 28%), particularly diarrhoea and nausea, but, with the antibacterial spectrum being narrower than with tetracycline, opportunistic infection is less troublesome. 

Pascual C, Crespo JF, Quiralte J, Lopez C, Wheeler G, Martin-Esteban M. In vitro detection of specific IgE antibodies to erythromycin. J Allergy Clin Immunol 1995 95(3) 668-71. 

LaForce CF, Szefler SJ, Miller MF, EbUng W, Brenner M. Inhibition of methylprednisolone elimination in the presence of erythromycin therapy. J Allergy Qin Immunol 1983 72(l) 34-9. 

Suez, D., and Szefler, S. J. (1986). Excessive accumulation of mucus in children with asthma A potential role for erythromycin A case discussion. J. Allergy Clin. Immunol. 77, 330-334. 

Agneu ( neu ) Moania complains to his physician of a fever and cough. His cough produces thick yellow-brown sputum. A stain of his sputum shows many Gram-positive, bullet-shaped diplococci. A sputum culture confirms that he has pneumonia, a respiratory infection caused by Streptococcus pneumoniae, which is sensitive to penicillin, erythromycin, tetracycline, and other antibiotics. Because of a history of penicillin allergy, he is started on oral erythromycin therapy. 

Lavrij sen K, Van Houdt J, Meulderm ans W, Janssens H Heykants J. The interaction of ketoconazole, itraconazole and erythromycin with the in vitro metabolism of antihistam ines in human liver microsomes. Allergy (1993) 48 (Suppl 16), 34. 

---