Macrolides

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  • Erythromycin and other macrolide antibiotics inhibit the metabolism of a number of drugs (eg oral anticoagulants, carbamazepine and theophylline) resulting in potentiation of effect.
  • In penicillin-allergic patients who fail to respond to, or are unable to tolerate erythromycin, clarithromycin may be an appropriate alternative.
  • Use clarithromycin in Helicobacter pylori eradication regimes.

CLARITHROMYCIN (First Line)

Therapy notes

MHRA advice: Hydroxychloroquine, chloroquine: increased risk of cardiovascular events when used with macrolide antibiotics; reminder of psychiatric reactions (February 2022) (www.gov.uk).

  • First-line choice in Helicobacter pylori eradication.  See eradication therapies.

Formulation

Tablets 250mg, 500mg

Formulation

Oral suspension 125mg/5mL

Formulation

Infusion 500mg

AZITHROMYCIN

Therapy notes

MHRA advice: Hydroxychloroquine, chloroquine: increased risk of cardiovascular events when used with macrolide antibiotics; reminder of psychiatric reactions (February 2022) (www.gov.uk).

Formulation

Tablets 250mg
Tablets 500mgOTC

Formulation

Oral suspension 200mg/5mL

ERYTHROMYCIN

Therapy notes

MHRA advice: Hydroxychloroquine, chloroquine: increased risk of cardiovascular events when used with macrolide antibiotics; reminder of psychiatric reactions (February 2022) (www.gov.uk).
MHRA advice: Erythromycin: caution required due to cardiac risks (QT interval prolongation); drug interaction with rivaroxaban (December 2020) (www.gov.uk).
MHRA advice: Erythromycin: update on known risk of infantile hypertrophic pyloric stenosis (December 2020) (www.gov.uk).

Formulation

Enteric coated tablets 250mg

Formulation

Oral suspension 125mg/5mL, 250mg/5mL

Formulation

Infusion 1 gram