Prep School Daily

Erythromycin, a macrolide antibiotic like azithromycin, destroys Gram-positive bacteria from the inside out by inhibiting the cell's ability to replicate and grow. Due to the potential for causing nausea and cramping, it is less popular, but it has some distinct advantages to warrant including it in your medicine chest. Erythromycin, also sold as Fish-Mycin by Thomas Labs, can safely be used in children and pregnant women. It is also an alternative to penicillin in those patients who are allergic to the latter.

The following information comes directly from The Ship’s Medicine Chest and Medical Aid at Sea, a government publication:

“Erythromycin Tablets, 250 mg

USE: For a variety of susceptible infections. Give this antibiotic only when medical advice from a physician has been received by radio. It may be useful for patients allergic to penicillin, and for some infections resistant to penicillin.

ADULT DOSAGE: One 250 mg tablet, four times a day (for serious infections dosage may be increased to two 250 mg tablets, four times a day); and continued for 48 hours or more after symptoms have subsided.

CAUTION: Occasionally, a skin rash may develop which will require that the drug be discontinued. If the drug is discontinued due to a sensitivity reaction, medical advice by radio should be obtained on alternate therapy. Sometimes abdominal discomfort, cramping, or nausea and vomiting may occur; these complaints usually diminish as therapy continues.”[i]

Erythromycin is most frequently used to treat the following infections:

Dental infections[ii]
Gastrointestinal

Campylobacter

250-500 mg, 3 times per day, 5 days (but be aware that erythromycin can also cause diarrhea)[iii]
250-500 mg, 4 times per day, 7-14 days[iv]

Cholera, 500 mg, 4 times per day, 3 days[v]

Respiratory

Bronchitis (only if caused by bacteria)

250-500 mg, 4 times per day, 7-14 days[vi]

Diphtheria, 14 days[vii]
Ear infections (keep in mind that many are resistant to erythromycin)[viii]

250-500 mg, 4 times per day, 7-14 days[ix]

Pneumonia

250-500 mg, 4 times per day, 7-14 days[x]

Whooping cough

250-500 mg, 4 times per day[xi]

Skin

Cellulitis

250-500 mg, 4 times per day, 7-14 days[xii]

Dog and cat bites

250-500 mg 3-4 times per day

3-7 days to prevent an infection after a bite
7-10 days to treat an infection that has developed after a bite[xiii]

Infected eczema[xiv]
Infected burns (usually only in a penicillin-allergic patient)

Treat for 2 days beyond resolution of infection[xv]

Infected insect bites or stings (usually only in penicillin-allergic patient)[xvi]
Lyme disease

250-500 mg, 4 times per day, 7-14 days[xvii]

Urogenital

Chlamydia

250-500 mg, 4 times per day, 7-14 days[xviii]

Gonorrhea

250-500 mg, 4 times per day, 7-14 days[xix]

Syphilis (early)

250-500 mg, 4 times per day, 7-14 days[xx]

Erythromycin is commonly used in children. Dosages administered to children are calculated by weight, 50 mg/kg/day divided into four doses given every six hours. For all patients, erythromycin should be taken with a glass of water on an empty stomach.

Side effects: Side effects that may occur with use include mild diarrhea, abdominal cramps, nausea, vomiting, loss of appetite.[xxi]

Caution: Erythromycin interacts with many drugs, including those for blood pressure and high cholesterol, as well as other antibiotics. While its use in breastfeeding women is generally safe, the baby should be monitored for diarrhea or rashes.[xxii]

Links to related posts:

Acquiring Antibiotics

Azithromycin

Cellulitis

Dog and Cat Bites

Antibiotic reference chart for guiding purchases

[i] The Ship’s Medicine Chest and Medical Aid at Sea, 1978, 278-79.

[ii] Cynthia Koelker, Armageddon Medicine, 2012, 151.