Macrolides are a class of antibiotics that includes erythromycin and its derivatives as well as azithromycin and clarithromycin. They inhibit bacterial protein synthesis and are used to treat various infections caused by bacteria, mycoplasma, chlamydia, and other microorganisms. Common adverse effects include GI upset, rashes, and drug interactions can occur when taken with other medications like theophylline. Nurses monitor patients for resolution of infections and potential adverse reactions during macrolide therapy.
Macrolides are a class of antibiotics that includes erythromycin and its derivatives as well as azithromycin and clarithromycin. They inhibit bacterial protein synthesis and are used to treat various infections caused by bacteria, mycoplasma, chlamydia, and other microorganisms. Common adverse effects include GI upset, rashes, and drug interactions can occur when taken with other medications like theophylline. Nurses monitor patients for resolution of infections and potential adverse reactions during macrolide therapy.
Macrolides are a class of antibiotics that includes erythromycin and its derivatives as well as azithromycin and clarithromycin. They inhibit bacterial protein synthesis and are used to treat various infections caused by bacteria, mycoplasma, chlamydia, and other microorganisms. Common adverse effects include GI upset, rashes, and drug interactions can occur when taken with other medications like theophylline. Nurses monitor patients for resolution of infections and potential adverse reactions during macrolide therapy.
Macrolides are a class of antibiotics that includes erythromycin and its derivatives as well as azithromycin and clarithromycin. They inhibit bacterial protein synthesis and are used to treat various infections caused by bacteria, mycoplasma, chlamydia, and other microorganisms. Common adverse effects include GI upset, rashes, and drug interactions can occur when taken with other medications like theophylline. Nurses monitor patients for resolution of infections and potential adverse reactions during macrolide therapy.
• Because erythromycin is acid-sensitive, it must be buffered or have an enteric
coating to prevent destruction by gastric acid.
• Erythromycin is absorbed in the duodenum.
• It’s distributed to most tissues and body fluids except, in most cases, cerebrospinal fluid (CSF).
• However, as a class, macrolides can enter the CSF when meninges are inflamed. Pharmacodynamics
• Macrolides inhibit ribonucleic acid (RNA)–dependent protein
synthesis by acting on a small portion of the ribosome, much like clindamycin. Pharmacotherapeutics • Erythromycin has a range of therapeutic uses.
• It provides a broad spectrum of antimicrobial activity against gram-positive and gram-
negative bacteria, including Mycobacterium, Treponema, Mycoplasma, and Chlamydia.
• It’s effective against pneumococci and group A streptococci.
• Staphylococcus aureus is sensitive to erythromycin; however, resistant strains may appear
during therapy.
• It’s the drug of choice for treating Mycoplasma pneumonia infections as well as pneumonia caused by Legionella pneumophila Drug interactions
• Erythromycin, azithromycin, and clarithromycin can increase
theophylline levels in patients receiving high dosages of theophylline, increasing the risk of theophylline toxicity.
• Clarithromycin may increase the concentration of carbamazepine
when the drugs are used together. Adverse reactions • epigastric distress
• nausea and vomiting
• diarrhea (especially with large doses)
• rashes
• fever
• eosinophilia (an increase in the number of eosinophils, a type of WBC)
• anaphylaxis Nursing process • Assessment
• Assess the patient’s infection before therapy and regularly throughout
therapy.
• Obtain a specimen for culture and sensitivity tests before giving the first dose. Therapy may begin pending results.
• Assess for adverse reactions and drug interactions.
• Assess the patient’s and family’s knowledge about drug therapy.
Key nursing diagnoses
• Risk for infection related to altered immune status
• Risk for deficient fluid volume related to adverse GI reactions
• Deficient knowledge related to drug therapy
Planning outcome goals
• The patient’s infection will resolve as evidenced by culture reports,
temperature, and WBC counts.
• The patient’s fluid volume will remain within normal limits as evidenced by intake and output.
• The patient and his family will demonstrate an understanding of drug
therapy. Implementation
• When giving the suspension, note the concentration.
• For best absorption, give the oral form with a full glass of water 1 hour before or 2 hours after meals.
• Coated tablets may be taken with meals.
• Tell the patient not to drink fruit juice with the drug.
• Chewable erythromycin tablets shouldn’t be swallowed whole.
• Coated tablets or encapsulated pellets cause less GI upset; they may be more tolerable in patients who have trouble tolerating erythromycin. • Reconstitute the drug according to the manufacturer’s directions, and dilute each 250 mg in at least 100 mL of normal saline solution.
• Infuse over 1 hour.
• Don’t give erythromycin lactobionate with other drugs.
• Monitor hepatic function (increased levels of alkaline phosphatase, alanine
aminotransferase, aspartate aminotransferase, and bilirubin may occur).
• Be aware that erythromycin estolate may cause serious hepatotoxicity in adults (reversible cholestatic jaundice). • Other erythromycin derivatives cause hepatotoxicity to a lesser degree.
• Patients who develop hepatotoxicity from erythromycin estolate may react similarly to treatment with other erythromycin preparations.
• Monitor the patient’s hydration status if adverse GI reactions occur.
