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Erythromycin lactobionate

(Synonyms: 红霉素乳糖酸盐) 目录号 : GC43627

A macrolide antibiotic and water-soluble form of erythromycin

Erythromycin lactobionate Chemical Structure

Cas No.:3847-29-8

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500mg
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产品描述

Erythromycin is a macrolide antibiotic that inhibits bacterial protein synthesis by targeting the 50S ribosomal subunit, blocking the progression of nascent polypeptide chains.[1] It is effective against a host of bacterial genera, including Streptococcus, Staphylococcus, and Haemophilus (MIC90s range from 0.015-2.0 mg/l).[2] Erythromycin is known to potently inhibit the cytochrome P450 isoform CYP3A4, which can affect the metabolism of numerous clinically relevant medications.[3],[4] Erythromycin lactobionate is a soluble salt of erythromycin that is typically used for intraperitoneal or intravenous injections.[5],[6]

Reference:
[1]. Wilson, D.N. The A-Z of bacterial translation inhibitors. Crit. Rev. Biochem. Mol. Biol. 44(6), 393-433 (2009).
[2]. Kanatani, M.S., and Guglielmo, B.J. The new macrolides. Azithromycin and clarithromycin. Western J. Med. 160(1), 31-37 (1994).
[3]. Westphal, J.F. Macrolide - induced clinically relevant drug interactions with cytochrome P-450A (CYP) 3A4: An update focused on clarithromycin, azithromycin and dirithromycin. Br. J. Clin. Pharmacol. 50(4), 285-295 (2000).
[4]. Bibi, Z. Role of cytochrome P450 in drug interactions. Nutr. Metab. (Lond) 5(27), 1-10 (2008).
[5]. Hirakata, Y., Kaku, M., Tomono, K., et al. Efficacy of erythromycin lactobionate for treating Pseudomonas aeruginosa bacteremia in mice. Antimicrobial Agents and Chemotherapy 36(6), 1198-1203 (1992).
[6]. Austin, K.L., Mather, L.E., Philpot, C.R., et al. Intersubject and dose-related variability after intravenous administration of erythromycin. British Journal of Clinical Pharmacology 10(3), 273-279 (1980).

Chemical Properties

Cas No. 3847-29-8 SDF
别名 红霉素乳糖酸盐
化学名 4-O-β-D-galactopyranosyl-D-gluconate erythromycin
分子式 C37H67NO13•C12H22O12 分子量 1092.2
溶解度 1mg/mL in water 储存条件 Store at -20°C
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1 mM 0.9156 mL 4.5779 mL 9.1558 mL
5 mM 0.1831 mL 0.9156 mL 1.8312 mL
10 mM 0.0916 mL 0.4578 mL 0.9156 mL
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Research Update

QTc-interval prolongation associated with slow intravenous Erythromycin lactobionate infusions in critically ill patients: a prospective evaluation and review of the literature

Pharmacotherapy 1996 Jul-Aug;16(4):663-74.PMID:8840374doi

Intravenous erythromycin has recently been associated with significant QTc interval prolongation, torsades de pointes, and sudden cardiac death. The prolonged the QTc interval attributed to erythromycin typically is associated with rapid infusion rates in excess of 10 mg/minute. We prospectively assessed the relationship between QTc interval prolongation and erythromycin administration by slow intravenous infusion (mean rate 8.9 +/- 3.5 mg/minute, range 3.9-16.7 mg/minute). Electrocardiographic (ECG) rhythm strips were prospectively obtained in 44 critically ill patients receiving intravenous antibiotics (22 received erythromycin and 22 ceftazidime, cefuroxime, cefotaxime, ceftriaxone, or ampicillin-sulbactam as controls). The ECG recordings were obtained immediately before and within 15 minutes after drug infusions. Only the first available set of ECG strips were evaluated. Two controls had evidence of hepatic dysfunction; no patients receiving erythromycin did. The QTc interval was calculated using Bazett's formula by two blinded investigators. For controls, mean +/- 1 SD (range) QTc intervals were 423 +/- 96 (300-550) msec at baseline and 419 +/- 96 (280-610) msec after infusion (p = 0.712). In contrast, in the erythromycin group, the interval was significantly prolonged from 524 +/- 105 (360-810) msec at baseline to 555 +/- 134 (400-980) msec after infusion (p = 0.034). No patients experienced a dysrhythmia as a consequence of erythromycin infusion. Despite slow rates of infusion, QTc interval prolongation was significant. The clinical importance of this finding remains to be determined.

Intravenous erythromycin lactobionate-induced severe nausea and vomiting

DICP 1989 Jan;23(1):40-4.PMID:2655295DOI:10.1177/106002808902300108.

Intravenous Erythromycin lactobionate has been used for several years to treat various infectious diseases. Several cases of severe nausea and vomiting associated with its use have been reported in Europe but only a few cases have been reported in the U.S. The official product information does not refer to severe nausea and vomiting associated with its intravenous use; however, we report six additional cases of severe nausea and vomiting associated with rapid administration of Erythromycin lactobionate, and review the current literature on the characteristics of this adverse effect.

Erythromycin lactobionate: pharmacokinetics and uterine tissue levels

Eur J Drug Metab Pharmacokinet 1987 Jul-Sep;12(3):153-60.PMID:3436337DOI:10.1007/BF03189891.

Erythromycin is well-known for its properties of tissular diffusion. An estimation of its concentration in uterine tissue seemed worthwhile, in order to justify the use of Erythromycin lactobionate in uterine infections by sensitive micro-organisms. The authors studied the uterine levels of this macrolid, after perfusion of 1g of Erythromycin lactobionate, over a period of one hour. The protocol involved a group of 15 women, who were to undergo a hysterectomy for benign non-inflammatory pathology. The uterine specimens and plasmatic pharmacokinetics of the antibiotic constitute the data. The concentrations of antibiotic were determined by microbiological methods. 2 sets of results emerge: during perfusion, the uterine erythromycin levels are equal or inferior to simultaneous serum levels. after perfusion, the uterine levels are superior to serum levels. A bicompartmental linear model was used, which simulated the tissular levels in standard treatment with Erythromycin lactobionate. If the erythromycin 4 micrograms/ml critical concentration is compared with uterine tissue concentration, the antibiotic may be expected to be active against a uterine affected by sensitive micro-organisms during a period of approximately 5 hours. This result must be confirmed by a clinical study.

Gastrointestinal side effects after intravenous Erythromycin lactobionate

Br J Clin Pharmacol 1986 Mar;21(3):295-9.PMID:3964530DOI:10.1111/j.1365-2125.1986.tb05193.x.

Ten healthy normal volunteers received an intravenous infusion of Erythromycin lactobionate over 60 min to a total dose of 800 mg (n = 9), and 524 mg (n = 1). Blood samples were collected at 10 min intervals for 100 min and gastric contents aspirated, via a nasogastric tube, from pre-dose to 105 min after start of infusion. Incidence and severity of three gastrointestinal symptoms (nausea, stomach discomfort and feelings of hunger), two CNS symptoms (dizziness and faintness) and a 'control' symptom (back pain) were measured using 100 mm visual analogue scales. Rate of infusion and plasma erythromycin concentration correlated with nausea (P less than 0.001) and stomach discomfort (P less than 0.001); plasma erythromycin concentration was also correlated with dizziness (P less than 0.05). Concentrations of active erythromycin in the aspirate were pH dependent. In one subject the concentration of erythromycin in the aspirate exceeded that in the plasma by 100 fold. Bile staining of samples containing the highest levels of microbiologically active erythromycin makes the origin of the erythromycin in these samples uncertain.

Effects of intravenous Erythromycin lactobionate in respiratory infections

J Int Med Res 1987 Jul-Aug;15(4):245-50.PMID:3653502DOI:10.1177/030006058701500409.

The antibiotic Erythromycin lactobionate given intravenously acts almost exclusively on Gram-positive bacteria. Even at high plasma and tissue concentrations there is an almost total absence of side-effects. It could be considered, therefore, as first choice in the treatment of patients with infectious respiratory diseases. Most of the 40 patients admitted to the present study were elderly and all had either acute or chronic and becoming acute respiratory disease. Their clinical symptoms and levels of phlogosis improved on treatment with Erythromycin lactobionate without any interruption of therapy due to side-effects and toxicity. The absence of unfavourable pharmacological interactions further enhances the usefulness of the drug. In view of the excellent response to monotherapy with Erythromycin lactobionate and the few groups of resistant bacteria found in those cases when it was possible to check, it was not considered necessary to investigate any synergistic association with other antibiotics. It can be concluded, therefore, that therapy with Erythromycin lactobionate in patients with infective respiratory disease is favourable and patients show excellent tolerability.