INDICES> super-hydration with erythromycin (cont)

["Janet McNeece" <jmcneece@gp.rah.sa.gov.au>]

The (Australian)  Data Sheet for Erythromycin Lactobionate (Abbott 
Laboratories )  gives a recommendation to dilute the required dose 
in a compatible fluid to a concentration of 1mg/ml  ie 1g in 1000ml 
of fluid for continuous infusion or 1-5mg/ml for intermittent 
infusion.  I am sure something similar would be listed in the 
American Data Sheet.  On recent contact with the manufacturer, if a 
patient is fluid restricted, then a dilution of 250mg in a minimum of 
250ml of preferably sodium chloride 0.9% was recommended asa possible 
alternative.  This is still to be infused slowly over at least 20 
minutes and preferably over 60 minutes. 
The textbook written by L. A Trissel  (Handbook on Injectable Drugs - 
10th edition) gives a  recommendation of  again 1mg/ml if given by 
slow continuous infusion  to minimise venous irritation.  If by 
intermittent infusion, one fourth of the daily dosage at a 
concentration of 1 to 5mg/kg in at least 100ml of infusion solution 
may be given over 20 to 60 minutes every 6 hours.  All this data is 
based upon minimising venous irritation (due to pH and osmolality)  
and not on the distribution of the drug. Hope this information is 
useful Janet McNeece
Senior Pharmacist
Drug Information Centre
Royal Adelaide Hospital



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