erythromycin
Sources réglementaires consultées
Indications approuvées
- Infections dues à des germes sensibles, notamment infections respiratoires, cutanées, odontogènes et à Chlamydia, lorsqu’un macrolide oral est indiqué.
Contre-indications
Absolues
- Hypersensibilité à l’érythromycine ou aux macrolides ; QT long, arythmie ventriculaire ou troubles électrolytiques non corrigés ; et traitement par astémizole, terfénadine, cisapride, pimozide, ergotamine/dihydroergotamine, lovastatine, simvastatine ou lomitapide.
Mises en garde cliniques
- Il peut prolonger le QT et provoquer des torsades de pointes ; éviter en cas de QT long, d’hypokaliémie ou d’hypomagnésémie, de bradycardie significative et avec d’autres médicaments allongeant le QT. — CIMA/AEMPS, ficha técnica 39690
- Mise en garde majeure · Il peut provoquer une hépatite cholestatique, une nécrose hépatique ou une insuffisance hépatique ; arrêter en cas de signes de dysfonction hépatique. — CIMA/AEMPS, ficha técnica 39690
- Mise en garde majeure · Une diarrhée et une colite à Clostridioides difficile peuvent survenir pendant ou après le traitement ; évaluer toute diarrhée importante et arrêter si le diagnostic est confirmé. — CIMA/AEMPS, ficha técnica 39690
Interactions médicamenteuses
- ModéréeSimvastatine et lovastatine
Mécanisme: L’inhibition du CYP3A4 augmente fortement l’exposition et le risque de myopathie et de rhabdomyolyse.
Recommandation: Arrêter ces statines pendant le traitement ; utiliser une alternative ne dépendant pas du CYP3A4.
CIMA/AEMPS, ficha técnica 39690
- ModéréeAlcaloïdes de l’ergot
Mécanisme: Il peut provoquer un ergotisme aigu par augmentation de l’exposition.
Recommandation: Ne pas administrer ensemble.
CIMA/AEMPS, ficha técnica 39690
- ModéréeMédicaments allongeant le QT
Mécanisme: Les effets sur la repolarisation sont additifs.
Recommandation: Éviter l’association, notamment avec le pimozide, le cisapride ou les antiarythmiques de classe IA/III.
CIMA/AEMPS, ficha técnica 39690
- ModéréeLomitapide
Mécanisme: L’inhibition du CYP3A4 augmente fortement l’exposition au lomitapide.
Recommandation: Ne pas administrer ensemble.
CIMA/AEMPS, ficha técnica 39690
Effets indésirables
Communs (≥1%)
Nausées, douleurs abdominales, diarrhée et vomissements
Rares mais graves
Anaphylaxie, hépatotoxicité sévère, arythmie ventriculaire et réactions cutanées sévères
Grossesse et allaitement
Utiliser pendant la grossesse uniquement si nécessaire. Il passe dans le lait ; mettre en balance le bénéfice de l’allaitement et le risque de diarrhée ou de sensibilisation chez le nourrisson.
Bibliographie récente (PubMed)
Acne vulgaris commonly affects adults, adolescents, and preadolescents aged 9 years or older. The objective of this study was to provide evidence-based recommendations for the management of acne. A work group conducted a systematic review and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of evidence and formulating and grading recommendations. This guideline presents 18 evidence-based recommendations and 5 good practice statements. Strong recommendations are made for benzoyl peroxide, topical retinoids, topical antibiotics, and oral doxycycline. Oral isotretinoin is strongly recommended for acne that is severe, causing psychosocial burden or scarring, or failing standard oral or topical therapy. Conditional recommendations are made for topical clascoterone, salicylic acid, and azelaic acid, as well as for oral minocycline, sarecycline, combined oral contraceptive pills, and spironolactone. Combining topical therapies with multiple mechanisms of action, limiting systemic antibiotic use, combining systemic antibiotics with topical therapies, and adding intralesional corticosteroid injections for larger acne lesions are recommended as good practice statements. Analysis is based on the best available evidence at the time of the systematic review. These guidelines provide evidence-based recommendations for the management of acne vulgaris.
Acne is one of the most common dermatological conditions to affect women of childbearing age, so it is important to consider the safety of long-term acne treatments on women who could become pregnant. In this review article, we clarify what management options are available to treat acne during pregnancy. Topical treatments, typically first-line for acne, such as azelaic acid, clindamycin, erythromycin, metronidazole, benzoyl peroxide, salicylic acid, dapsone, and retinoids, were reviewed. Systemic treatments, such as zinc supplements, cephalexin, cefadroxil, amoxicillin, azithromycin, erythromycin, and corticosteroids, typically second-line for acne, were also reviewed. Alternative treatments such as light therapy and cosmetic procedures were also evaluated. Due to recommendation of sunscreen utilization during acne treatments, sunscreen usage during pregnancy was also assessed. Management of acne during unplanned pregnancy was discussed in further detail regarding safety and adverse effects. Through summarized tables and examples of studies demonstrating safety and efficacy of treatments, the following is a resource for providers and patients to utilize for management of acne during pregnancy. This sheet is about exposure to erythromycin during pregnancy and while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider. Roxithromycin is not approved for marketing in the United States by the U.S. Food and Drug Administration, but is available in other countries. Because of the low levels of roxithromycin in breastmilk, it would not be expected to cause adverse effects in breastfed infants. Monitor the infant for possible effects on the gastrointestinal flora, such as diarrhea, candidiasis (thrush, diaper rash). Unconfirmed epidemiologic evidence indicates that the risk of infantile hypertrophic pyloric stenosis might be increased by maternal use of macrolide ant