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