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Erythromycin lactobionate Intravenous Infusion for Adults
Who can administer
May be administered by registered competent doctor or nurse/midwife
Important information
- Longer infusion times are recommended in patients with risk factors for arrhythmias or previous evidence of arrhythmias
- Monitor closely for thrombophlebitis-consider IV to PO switch as soon as is appropriate (can use same doses orally)
- There are numerous important interactions (including those with QTc prolonging agents) - check current BNF
- See under 'Dose' for adjustments required in renal impairment
- NOT a suitable agent for surgical prophylaxis (GUH guidelines)
Available preparations
Erythrocin 1g vial
Reconstitution
Water for injection
- 20ml per 1g vial
- Dilute further prior to administration
Infusion fluids
Sodium chloride 0.9%
Methods of intravenous administration
Intermittent intravenous infusion ONLY (using an electronically controlled infusion device- due to risk of thrombophlebitis)
- Add doses of between 500mg and 1g to 250ml infusion fluid and administer over 60 minutes
- Add doses of 500mg or less to 100ml infusion fluid and administer over 60 minutes
- Longer infusion times are recommended for patients with arrhythmias
Fluid restricted patients (ref 2)
- Add 1g to 100ml infusion fluids, and administer via central line. Monitor carefully
- If catheter in ventricle can cause extension of Q-R interval
Dose in adults
| Severity | Dose |
|---|---|
| Mild to moderate infections (if oral route compromised) | Give 6.25mg/kg every six hours e.g. 500mg every six hours |
| Severe infection |
Give 12.5mg/kg (max 1g)(ref 1) every six hours |
Gastrointestinal stasis (ref 3)
- Give 3mg/kg three times per day
- For use in Critical Care- see local guideline
Renal Impairment (ref 1)
| eGFR (ml/minute/1.73m2) | Dose |
|---|---|
| less than 10 |
Give usual dose. Monitor for ototoxicity, especially at high doses However, the BNF recommends a maximum 500mg every eight hours (1.5g daily) in severe renal impairment (ototoxicity) (ref 3) |
Hepatic impairment - Use with caution
Storage
- Store below 250C
References
SPC September 2020
1. Renaldrugdatabase accessed online December 2021
2. Critical Care Group Minimum Infusion Volumes for fluid restricted critically ill patients 2012
3: BNF accessed online Dec 9th 2021
Therapeutic classification
Macrolide antibiotic