Erythromycin antibodies

Digoxin toxicity occurred in a neonate who was also given erythromycin (274). She had bradycardia and coupled extra beats. Digoxin and erythromycin were withdrawn and she was given antidigoxin antibodies. Her plasma digoxin concentration, which had previously been 1.8 ng/ml, had risen to 8.0 ng/ml. 

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. 

All cases of Legionella IE have had an extended febrile course over months and high mAi-Legionella antibody titers and have occurred in patients with prosthetic valves." When special media are used, blood cultures will reveal this organism. Prolonged parenteral therapy with either doxycycline or erythromycin, with prolonged oral therapy (e.g., 6 to 17 months), has elicited cure in some patients." Most patients require concomitant valve replacement. 

Gudjonsson H (1972) Experiments to induce febrile Jarisch-Herxheimer reaction in syphilitic rabbits with penicilhn and erythromycin. Acta Derm Venerol 52 493 Haddad ZH, Korotzer JL (1971) In vitro studies on the mechanism of penicilhn and ampicil-lin drug reactions. Int Arch Allergy Appl Immunol 41 72 Haimovich J, Sela M, Dewdney JM, Batchelor FR (1967) Antipenicilloyl antibodies. Detection with penicilloylated bacteriophage and isolation with a specific immunoadsorbent. Nature 214 1369... 

Antibodies to erythromycin in humans have not as yet been found by in vitro methods. Serologic tests have been performed by Davies and Pepys (1975) who tried to find antibodies against spiramycin in a patient suffering from asthma and rash following contact with spiramycin at work, but the results were negative. 

Experiments have been carried out in different animal species. Immunization of mice with erythromycin in complete Freund s adjuvant has led to the production of antibodies which agglutinated erythromycin-coated red blood cells (White 1965). Studies in rats and guinea pigs, however, gave no evidence of an erythromycin-specific immune response, as confirmed by skin tests (Raab 1977). 

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