Fourteen-and Fifteen-Membered Macrolides

Prior to 1997, erythromycin was an alternative antibiotic choice to amoxicillin for prophylaxis prior to dental, oral, esophageal, and respiratory procedures to prevent infective endocarditis (IE). Erythromycin is an alternative choice for treating a recurrence of acute rheumatic fever in patients allergic to penicillin [12]. Recently updated recommendations by the American Heart Association for IE 

5-1 g every 6 hr is recommended, but use of this route is limited due to the possibility of phlebitis resulting. A summary of some of the clinical indications for erythromycin is given in Table I. 

Organism/Disease Erythromycin Clarithromycin Azithromycin Dirithromycin Roxithromycin Rokitamycin 

Source Adapted in part from Alvarez-Elcoro and Enzler [3] by permission. 

Abbreviations N, no Y, yes CR, case reports support activity IE, infective endocarditis LGV, lymphgranuloma venereum PID, pelvic inflammatory disease MAC, M. avium complex IV, intravenous MN, metronidazole STD, sexually transmitted disease ND, no published data. 

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