1.Effects of Erythromycin and New Macrolides on the Serum Theophylline Level and Clearance.
Heung Bum LEE ; Yong Chul LEE ; Yang Keun RHEE
Tuberculosis and Respiratory Diseases 1998;45(3):546-552
BACKGROUND: Up to 90% of a theophylline dose is biotransformed, by interaction with one or more the variants of the cytochrome P-450 drug metabolism system. Macrolides affect the elimination of theophylline by influencing on the microsomal enzyme systems. We evaluate the effect of erythromycin and new macrolides on the serum theophylline level and clearance. METHOD: Subjects consisted of moderate asthmatic patients with normal renal and hepatic functions. All subjects were non-smokers and treated with oral theophylline 400mg per day. We randomly assigned 53 patients into four groups. Each group was treated with one macrolides, the first group erythromycin(n: 19, 500 mg bid), second roxitbromycin (n: 14. 150 mg bid), third clarithromycin (n: 10, 250 mg bid) and fourth azithromycin(n: 10, 250 mg bid). We measured the serum theophylline level and clearance at three intervals, at pretreatment, after the first and fourth week after receiving the following macrolides, erythromycin, roxithromycin and clarithromycin. When azithromycin was administered, the serum theophylline level was measured at pretreatment and after one week of treatment They were measured by a computerized program of Bayesian method. RESULTS: When compared with control, erytbromycin and roxithromycin-treated groups had a significantly elevated serum theophylline level and decreased clearance. However, there were no significant changes of the serum theophylline level and clearance in clarithromycin and azithromycin-treated groups. CONCLUSION: These results suggest that theophylline dose may need to be readjusted and have periodic drug monitoring when erythromycin or roxithromycin is administered concurrenfly.
Azithromycin
;
Bayes Theorem
;
Clarithromycin
;
Cytochrome P-450 Enzyme System
;
Drug Monitoring
;
Erythromycin*
;
Humans
;
Macrolides*
;
Metabolism
;
Roxithromycin
;
Theophylline*
2.The effect of low-dose longterm erythromycin on bronchietasis.
Young Whan KIM ; Yeon Mok OH ; Man Pyo JUNG ; Chul Gyu YOO ; Sung Koo HAN ; Young Soo SHIM ; Keon Youl KIM ; Yong Chol HAN
Tuberculosis and Respiratory Diseases 1993;40(4):390-394
No abstract available.
Erythromycin*
3.Emergence of macrolide resistance and clinical use of macrolide antimicrobials in children.
Korean Journal of Pediatrics 2008;51(10):1031-1037
Macrolide antimicrobial agents including erythromycin, roxithromycin, clarithromycin, and azithromycin are commonly used in the treatment of respiratory tract infections in children. Newer macrolides that have structural modifications of older drug erythromycin show improved change in the spectrum of activity, dosing, and administration. However, recent studies reported that increasing use of macrolide antibiotics is the main force driving the development of macrolide resistance in streptococci. In particular, azithromycin use is more likely to select for macrolide resistance with Streptococcus pneumoniae than is clarithromycin use, a possible reflection of its much longer half life. Recently, erythromycin resistance rates of S. pneumoniae and Streptococcus pyogenes are rapidly increasing in Korea. Two main mechanisms of acquired macrolide resistance have been described, altered binding site on the bacterial ribosome encoded by the ermB gene and active macrolide efflux pump encoded by the mef gene. Relationship between the susceptibility of S. pneumoniae and the response to macrolides has been shown in studies of acute otitis media, but less clear in cases of pneumonia. This article reviews the spectrum of activity, pharmacokinetic properties, mechanisms of action and resistance, and clinical implication of resistance on the treatment of respiratory tract infections in children.
Anti-Bacterial Agents
;
Anti-Infective Agents
;
Azithromycin
;
Binding Sites
;
Child
;
Clarithromycin
;
Erythromycin
;
Half-Life
;
Humans
;
Korea
;
Macrolides
;
Otitis Media
;
Pneumonia
;
Respiratory Tract Infections
;
Ribosomes
;
Roxithromycin
;
Streptococcus pneumoniae
;
Streptococcus pyogenes
4.Detection of ermAM Gene and mefA Gene in Erythromycin-resistant Streptococcus Pyogenes.
Yun Jeong KIM ; Hye Soo LEE ; Sam Im CHOI ; Seon Ju KIM
Korean Journal of Infectious Diseases 1999;31(6):494-499
BACKGROUND: The mechanism of erythromycin resistance of Streptococcus pyogenes results from target modification or active efflux. The purpose of this study was to determine the positive rate of ermAM gene modifying 23S rRNA and that of mefA gene related with efflux for erythromycin-resistant S. pyogenes. METHODS: The minimal inhibitory concentrations (MICs) of erythromycin, azithromycin, clarithromycin, and clindamycin against S. pyogenes were tested by agar dilution method. ermAM and mefA genes were amplified by polymerase chain reaction (PCR) for 32 strains of erythromycin-resistant S. pyogenes. RESULTS: Among the 32 erythromycin-resistant S. pyogenes strains, 20 (62.5%) strains were positive for ermAM gene and 10 (31.1%) for mefA gene. Eighteen (90.0%) out of 20 strains with ermAM gene showed high-level erythromycin resistance (MIC> OR =64 microgram/mL), while all ten strains with mefA gene had low-level erythromycin resistance (MIC< OR =16 microgram/mL). CONCLUSION: Two-thirds of the S. pyogenes strains acquired erythromycin resistance by modification of target site, while the others by active efflux. Each mechanism of resistance is closely associated with range of MICs of erythromycin.
Agar
;
Azithromycin
;
Clarithromycin
;
Clindamycin
;
Erythromycin
;
Polymerase Chain Reaction
;
Streptococcus pyogenes*
;
Streptococcus*
5.A comparative efficacy and safety study of clarithromycin, roxithromycin and erythromycin stearate in mild pneumonia.
Osman Nuri HATIPOGLU ; Yucel TASAN
Yonsei Medical Journal 2000;41(3):340-344
The efficacy and safety of clarithromycin, roxithromycin and erythromycin stearate in mild pneumonia were compared in an open randomized trial. Eighty-six male patients, doing their obligatory military service, ranging between 19 and 24 years of age (mean 20), were randomly treated: 29 with clarithromycin 500 mg 12-hourly, 30 with roxithromycin 150 mg 12-hourly, and 27 with erythromycin stearate 500 mg 6-hourly, each course being administered for 10 days. Seventy-eight patients were able to be evaluated for efficacy, 28 receiving clarithromycin, 28 roxithromycin, and 22 erythromycin stearate. There were no significant differences among the groups in terms of clinical success rates (clinical cure or improvement: 89% for clarithromycin, 82% for roxithromycin, and 73% for erythromycin stearate, p = 0.32). However, we found that there were significant differences among the groups in terms of clinical cure rates (75% for clarithromycin, 64% for roxithromycin, and 41% for erythromycin stearate, p = 0.04). Adverse events, mostly gastrointestinal, caused discontinuation of treatment in 3.4% of the patients in the clarithromycin group, in 6.6% of the patients in the roxithromycin group, and in 18.5% of the patients in the erythromycin stearate group. The results indicate that there were no statistically significant differences among the three treatment groups in terms of clinical success rates, but that clarithromycin and roxithromycin were better tolerated.
Adult
;
Antibiotics, Macrolide/therapeutic use*
;
Antibiotics, Macrolide/adverse effects
;
Clarithromycin/therapeutic use*
;
Clarithromycin/adverse effects
;
Comparative Study
;
Erythromycin/therapeutic use*
;
Erythromycin/analogs & derivatives*
;
Erythromycin/adverse effects
;
Female
;
Human
;
Male
;
Pneumonia/radiography
;
Pneumonia/physiopathology*
;
Pneumonia/microbiology
;
Pneumonia/drug therapy*
;
Radiography, Thoracic
;
Roxithromycin/therapeutic use*
;
Roxithromycin/adverse effects
6.Detection and the antibiotic susceptibility analysis of mycoplasma and chlamydia in urogenital tract infections of 327 cases patients with tubal infertility.
Yun ZHOU ; Xue-Lan XU ; Chun-Ping WANG ; Ming ZHOU ; Xiu-Hua ZENG
Chinese Journal of Experimental and Clinical Virology 2011;25(3):201-204
OBJECTIVETo explore the effects of mycoplasma and chlamydia infections on tubal infertilityand to assess the antibiotic susceptibility and resistance of female urogenital, and consequently to guide clinical rational drug use.
METHODS327 tubal infertility women as infertility group and 286 healthy pregnant women as control group were randomly selected, detected chlamydia trachomatis (CT), ureaplasma urealyticum (UU) and mycoplasma hominis (MH) in cervical secretions and drug resistance of UU and MH.
RESULTSCT infection rates (14.99%), UU infection rates (23.24%), UU + MH infection rates (29.05%),CT + UU + MH infection rates (9.17%) and total infection rates (88.99%) in infertility group is higher than those (order: 2.80%, 6.99%, 8.39%, 4.55%, 29.02%) in the control group, comparisons of two groups are statistically significant differences (P < 0.05), the susceptibility of UU to roxithromycin (sensitivity is 96.05%), josamycin (sensitivity is 96.05%), tetracycline (sensitivity is 82.89%), vibramycin( sensitivity is 92.11%) and clarithromycin (sensitivity is 96.05%) were relatively high and low to ciprofloxacin and acetyl spiramycin. The susceptibility of MH to josamycin (sensitivity is 95.83%), vibramycin (sensitivity is 91.67%), minocin (sensitivity is 83.33%) and actinospectacin (sensitivity is 75.00%) were relatively high and low to erythromycin, azithromycin, roxithromycin and clarithromycin. UU + MH was only sensitive to josamycin (sensitivity is 90.52%), high resistance (77.89% -91.58%) to erythromycin, azithromycin, acetyl spiramycin, ciprofloxacin, ofloxacin, azithromycin and clarithromycin.
CONCLUSIONInfection of CT, UU, MH and tubal infertility have certain relevance,the rates of CT, UU and MH infection in tubal infertility patients higher than fertile people. For many commonantibacterial drugs, UU, MH and UU + MH has strong resistance, the etiology detection and using adapted antibios should be taken seriously in clinical treatment.
Adult ; Anti-Bacterial Agents ; pharmacology ; Azithromycin ; pharmacology ; Chlamydia ; Chlamydia Infections ; complications ; microbiology ; Clarithromycin ; pharmacology ; Doxycycline ; pharmacology ; Erythromycin ; pharmacology ; Female ; Humans ; Infertility, Female ; etiology ; microbiology ; Josamycin ; pharmacology ; Microbial Sensitivity Tests ; Minocycline ; pharmacology ; Mycoplasma ; Mycoplasma Infections ; complications ; microbiology ; Roxithromycin ; pharmacology ; Spectinomycin ; pharmacology ; Tetracycline ; pharmacology ; Ureaplasma urealyticum ; pathogenicity ; Urogenital System ; microbiology ; Young Adult
7.Erythromycin Induced Nightmares.
Maria E MØLLER ; Qasim AZIZ ; Jacob JUEL
Journal of Neurogastroenterology and Motility 2016;22(3):539-540
No abstract available.
Dreams*
;
Erythromycin*
8.Effect of erythromycin-Bromhexine combination in lower respiratory tract infections.
Journal of the Philippine Medical Association 0000;():0-
Thirty pediatric patients admitted for fever, cough and respiratory distress, suffering from various types of lower respiratory tract infections were treated with oral Bisolvonat, a combination of erythromycin and bromhexine. The methods and materials clinical response and side effects are described. After evaluating the results of the study, it appears that we have a very potent and effective drug in Bisolvanat for use in the treatment of the different lower respiratory tract infections. It was very well tolerated, very minimal side effects were noted and the response, with varying etiologic microorganisms were encouraging.(Summary)
Erythromycin, Bromhexine
9.T Typing and Antimicrobial Susceptibility of Streptococcus pyogenes in Clinical Isolates.
Korean Journal of Clinical Pathology 2000;20(1):62-68
BACKGROUND: As invasive streptococcal infections are increasing recently and the resistance rate to either erythromycin or clindamycin is elevating, epidemiologic surveillance and appropriate guideline for antibiotic use are required. Geographical epidemiologic characteristics with T typing and antibiotic resistance rate were investigated. METHODS: Distributions of T types according to geographical areas and sources of specimens were analyzed with 82 strains of Streptococcus pyogenes isolated from clinical samples in Seoul and Chinju. Antibiotic susceptibility test was performed for penicillin G, cephalothin, erythromycin, azithromycin, clarithromycin, clindamycin, chloramphenicol, and ofloxacin with agar dilution method. Antibiotic resistance rates were analyzed according to geographical areas, sources of specimens and T types. RESULTS: The most common T types were T12, T1 and T28 in decreasing order. The distribution of T types between Seoul and Chinju was different. While T1, T3, and T6 were frequent in throat or other respiratory specimens, T12, T28, and B3264 were common in blood or closed pus. The resistance rate to erythromycin, azithromycin, and clarithromycin was 20%, 13% to clindamycin, and 49% to tetracycline, respectively. None of the isolates were resistant to penicillin G, cephalothin, chloramphenicol, or ofloxacin. The isolates from Chinju showed higher resistance rate than the strains from Seoul. The isolates from blood or closed pus had higher resistance rate compared to those of throat or sputum. T28 and T6 strains presented higher resistance rate than other T types. CONCLUSIONS: As distributions of T types were variable according to geographical areas or sources of specimens, continuous microbiological and epidemiological surveillance for invasive streptococcal infections are needed. Minimizing unnecessary antibiotic use or acknowledging the severity of resistance are necessary, because the resistant proportions are increasing against macrolide, clindamycin and tetracycline.
Agar
;
Azithromycin
;
Cephalothin
;
Chloramphenicol
;
Clarithromycin
;
Clindamycin
;
Drug Resistance, Microbial
;
Epidemiological Monitoring
;
Erythromycin
;
Gyeongsangnam-do
;
Ofloxacin
;
Penicillin G
;
Pharynx
;
Seoul
;
Sputum
;
Streptococcal Infections
;
Streptococcus pyogenes*
;
Streptococcus*
;
Suppuration
;
Tetracycline
10.Comparison of the Antibiotic Resistance of Helicobacter pylori Isolated in Jinju Over a 15-year Period.
Ji Hyun SEO ; Sang Il KOO ; Hee Shang YOUN ; Jin Su JUN ; Jae Young LIM ; Chan Hoo PARK ; Hyang Ok WOO ; Hyung Lyun KANG ; Seung Chul BAIK ; Woo Kon LEE ; Myung Je CHO ; Kwang Ho RHEE
Journal of Bacteriology and Virology 2012;42(4):305-312
The aims of this study were to investigate the changing pattern of Helicobacter pylori antibiotic resistance in Jinju over a 15-year period. H. pylori strains were isolated from 170 adults living in Jinju from 1985-1989, 1990-1994 and 1995-1999, and from 23 adults living in Cheongju from 1995 to 1999. Susceptibility to erythromycin, clarithromycin, azithromycin, amoxicillin, tetracycline, metronidazole, furazolidone, levofloxacin, ciprofloxacin, moxifloxacin, and rifabutin was tested using the serial two-fold agar dilution method. Moxifloxacin resistance significantly increased in Jinju from 1985-1989 (0%) to 1995-1999 (14.9%) (p < 0.0001). Resistance to amoxicillin was increasesed trend to decreased trend from 1985 to 1999 (p = 0.033), whereas metronidazole resistance decreased from 37.5% to 21.3%. Resistance to furazolidone was greater from 1985-1989 (9.4%) than in 1995-1999 (2.1%). In comparing Jinju and Cheongju, minimal inhibitory concentrations (MICs) of tetracycline and levofloxacin among H. pylori isolated from Jinju were lower than for isolates from Cheonju (p < 0.05). The levofloxacin resistance rate was higher in Cheongju than in Jinju (p = 0.02). No macrolide resistance was observed in Cheongju. Overall, we did not observe any remarkable antimicrobial resistance increase of H. pylori strains isolated from Jinju over 15 years. The MIC distributions of antimicrobials and antimicrobial resistant rates were time- and region-specific among different strains. Future anti-H. pylori eradication regimens should be designed based on the changing patterns of antimicrobial resistance according to the resident area.
Adult
;
Agar
;
Amoxicillin
;
Anti-Infective Agents
;
Aza Compounds
;
Azithromycin
;
Ciprofloxacin
;
Clarithromycin
;
Drug Resistance, Microbial
;
Erythromycin
;
Furazolidone
;
Helicobacter
;
Helicobacter pylori
;
Humans
;
Metronidazole
;
Ofloxacin
;
Quinolines
;
Rifabutin
;
Tetracycline