药品信息:
部分中文福爱力信息资料(仅供参考)
【别名】威霉素;福爱力;新红康; 【外文名】Erythromycin, EM, EMU-V, Eryc, Ethryn, E-Mycin, Gluceptate, Ilotycin 【成分】 由链霉素Stretomyces erythreus所产生,是一种碱性抗生素。其游离碱供口服用,乳糖酸盐供注射用。此外,尚有其琥珀酸乙酯(琥乙红霉素)、丙酸酯的十二烷基硫酸盐(依托红霉素)供药用。 【性状】 红霉素为白色或类白色的结晶或粉末;无臭,味苦;微有引湿性。在甲醇、乙醇或丙酮中易溶,在水中极微溶解。 【药理作用】 抗菌谱与青霉素近似,对革兰阳性菌,如葡萄球菌、化脓性链球菌、绿色链球菌、肺炎链球菌、粪链球菌、梭状芽孢杆菌、白喉杆菌等有较强的抑制作用。对革兰阴性菌,如淋球菌、螺旋杆菌、百日咳杆菌、布氏杆菌、军团菌、以及流感嗜血杆菌、拟杆菌也有相当的抑制作用。此外,对支原体、放线菌、螺旋体、立克次体、衣原体、奴卡菌、少数分枝杆菌和阿米巴原虫有抑制作用。金黄色葡萄球菌对本品易耐药。 【适应证】抗菌谱与青霉素相似,且对支原体,衣原体,立克次体等及军团菌有抗菌作用。适用于支原体肺炎、沙眼衣原体引起的新生儿结膜炎、婴儿肺炎、生殖泌尿道感染(包括非淋病性尿道炎)、军团菌病、白喉(辅助治疗)及白喉带菌者、皮肤软组织感染、百日咳、敏感菌(流感杆菌、肺炎球菌、溶血性链球菌、葡萄球菌等)引起的呼吸道感染(包括肺炎)、链球菌咽峡炎、李斯德菌感染、风湿热的长期预防及心内膜炎的预防、空肠弯曲菌肠炎,以及淋病、梅毒、痤疮等。 【不良反应及注意事项】胃肠道反应有腹泻、恶心、呕吐、胃绞痛、口舌疼痛、胃纳减退等,其发生率与剂量大小有关。过敏反应表现为药物热、皮疹、嗜酸粒细胞增多等,发生率为0.5~1%。孕妇及哺乳期妇女慎用。 必须注意:1.红霉素为抑菌性药物,给药应按一定时间间隔进行,以保持体内药物浓度,利于作用发挥。 2.红霉素片应整片吞服,若服用药粉,则受胃酸破坏而发生降效。幼儿可服用对酸稳定的酯化红霉素。金黄色葡萄球菌对本品易耐药。 3.与β-内酰胺类药物联合应用。一般认为可发生降效作用。 4.本品可阻挠性激素类的肝肠循环、与口服避孕药合用可使之降效。 5.红霉素在酸性输液中破坏降效,一般不应与低pH的葡萄糖输液配伍。在5%~10%葡萄糖输液500ml中,添加维生素C注射液(抗坏血酸钠1g)或5%碳酸氢钠注射液0.5ml使pH升高到6左右,再加红霉素乳糖酸盐,则有助稳定。 【药物相互作用】 1、β-内酰胺类药物与本品联合应用,一般认为可发生降效作用。 2、本品可阻挠性激素类的肠肝循环,与口服避孕药合用可使之降效。 3、红霉素在酸性输液中破坏降效,一般不应与低pH的葡萄糖输液配伍。在5%-10%葡萄糖输液500ml中,添加维生素C注射液(抗坏血酸1g)或5%碳酸氢钠注射液0.5ml使pH升到6左右,再加红霉素乳糖盐,则有助稳定。 【用法及用量】口服,成人一日1~2g,分3~4次服。小儿每日按体重30~50mg/kg,分3~4次服。治疗军团菌病,成人每日2~4g,分4次服。治疗沙眼、结膜炎、角膜炎、用眼膏涂于眼睑内。 静滴:每6小时1次,每千克体重用3.75~5mg。必要时1次可增至每千克体重10mg。用时,将乳糖酸红霉素溶于10ml灭菌注射用水中,再添加到输液500ml中,缓慢滴入(最后稀释浓度一般为>=0.1%)。 【规格】片:0.1g, 0.125g. 针(粉):0.25g,0.3g.
Erythromycin is indicated in the treatment of infections caused by susceptible strains of the designated organisms in the diseases listed below:
Upper respiratory tract infections of mild to moderate degree caused by Streptococcus pyogenes, Streptococcus pneumoniae, or Haemophilus influenzae (when used concomitantly with adequate doses of sulfonamides, since many strains of H. influenzae are not susceptible to the erythromycin concentrations ordinarily achieved). (See appropriate sulfonamide labeling for prescribing information).
Lower respiratory tract infections of mild to moderate severity caused by Streptococcus pneumoniae or Streptococcus pyogenes.
Listeriosis caused by Listeria monocytogenes.
Pertussis (whooping cough) caused by Bordetella pertussis. Erythromycin is effective in eliminating the organism from the nasopharynx of infected individuals rendering them noninfectious. Some clinical studies suggest that erythromycin may be helpful in the prophylaxis of pertussis in exposed susceptible individuals. Respiratory tract infections due to Mycoplasma pneumoniae.
Skin and skin structure infections of mild to moderate severity caused by Streptococcus pyogenes or Staphylococcus aureus (resistant staphylococci may emerge during treatment).
Diphtheria: Infections due to Corynebacterium diphtheriae, as an adjunct to antitoxin, to prevent establishment of carriers and to eradicate the organism in carriers.
Erythrasma: In the treatment of infections due to Corynebacterium minutissimum.
Syphilis caused by Treponema pallidum: Erythromycin is an alternate choice of treatment for primary syphilis in penicillin-allergic patients. In primary syphilis, spinal fluid examinations should be done before treatment and as part of follow-up after therapy.
Intestinal amebiasis caused by Entamoeba histolytica (oral erythromycins only). Extraenteric amebiasis requires treatment with other agents.
Acute pelvic inflammatory disease caused by Neisseria gonorrhoeae: Erythromycin lactobionate for injection, USP followed by erythromycin base orally, as an alternative drug in treatment of acute pelvic inflammatory disease caused by N. gonorrhoeae in female patients with a history of sensitivity to penicillin. Patients should have a serologic test for syphilis before receiving erythromycin as treatment of gonorrhea and a follow-up serologic test for syphilis after 3 months.
Erythromycins are indicated for the treatment of the following infections caused by Chlamydia trachomatis: conjunctivitis of the newborn, pneumonia of infancy, and urogenital infections during pregnancy. When tetracyclines are contraindicated or not tolerated, erythromycin is indicated for the treatment of uncomplicated urethral, endocervical, or rectal infections in adults due to Chlamydia trachomatis.
When tetracyclines are contraindicated or not tolerated, erythromycin is indicated for the treatment of nongonococcal urethritis caused by Ureaplasma urealyticum.
Legionnaires' Disease caused by Legionella pneumophila. Although no controlled clinical efficacy studies have been conducted, in vitro and limited preliminary clinical data suggest that erythromycin may be effective in treating Legionnaires' Disease.
|