Disclaimer to the Online Edition
This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.
Erythromycin
Indication
- A macrolide antibiotic primarily used in neonates for the treatment of infections caused by Chlamydia and Ureaplasma
- Ophthalmic ointment is used for prophylaxis of ophthalmia neonatorum
Dosage Guidelines
- Injection: 5 – 10 mg/kg/dose IV q6h
- Ophthalmic ointment:
- Prophylaxis: Apply 0.5-1 cm of ointment in each conjunctival sac x 1 dose
- Treatment: BID to both eyes for 7 to 14 days
Administration
- Ophthalmic
- IV intermittent slow infusion over 30 minutes
- To make 10 mL of a 5 mg/mL solution:
- Reconstitution: add 10 mL sterile water for injection to a 500 mg vial (concentration = 50mg/mL)
- Draw up 1 mL of the 50 mg/mL reconstituted solution
- Add to 9 mL normal saline to make a total volume of 10 mL (final concentration = 5 mg/mL)
Adverse Effects
- Vomiting, diarrhea, abdominal pain, feeding intolerance
- Risk of hypertrophic pyloric stenosis (greatest in neonates less than 14 days of age)
- Hypotension, prolonged Q-T interval on ECG, thrombophlebitis with IV infusion
Comments
- Monitor heart rate and blood pressure during infusion
- Monitor liver function tests and bilirubin weekly
- Erythromycin may inhibit caffeine metabolism. Monitor for tachycardia and reduce caffeine dose by 25-50% if present
Supplied As
- 0.5% ophthalmic ointment
- 500 mg vial
- 5 mg/mL patient specific syringe, prepared by Pharmacy