Drug of choice in peussis is:
ERYTHROMYCIN It was isolated from Streptomyces erythreus in 1952. Since then it has been widely employed, mainly as alternative to penicillin. Water solubility of erythromycin is limited, and the solution remains stable only when kept in cold. A . As an alternative to penicillin 1 . Streptococcal pharyngitis, tonsillitis, mastoiditis and community acquired respiratory infections caused by pneumococci and H. influenzae respond equally well to erythromycin. It is an alternative drug for prophylaxis of rheumatic fever and SABE. However, many bacteria resistant to penicillin are also resistant to erythromycin. 2. Diphtheria: acute stage as well as for carriers-7 day treatment. Some prefer it over penicillin. Antitoxin is the primary treatment. 3. Tetanus: as an adjuvant to antitoxin, toxoid therapy. 4. Syphilis and gonorrhoea: only if other alternative drugs, including tetracyclines also cannot be used: relapse rates are higher. 5. Leptospirosis: 250 mg 6 hourly for 7 days in patients allergic to penicillins. B. As a first choice drug for 1 . Atypical pneumonia caused by Mycoplasma pneumoniae: rate of recovery is hastened. 2. Whooping cough: a 1-2 week course of erythromycin is the most effective treatment for eradicating B. peussis from upper respiratory tract. However, effect on the symptoms depends on the stage of disease when treatment is staed. (a) Prophylactic: during the 10 day incubation period-disease is prevented (b) Catarrhal stage: which lasts for about a week-erythromycin may abo the next stage or reduce its duration and severity. (c) Paroxysmal stage: lasting 2-4 weeks-no effect on the duration and severity of &;croup&; despite eradication of the causative organism. (d) Convalescent stage: during which &;croup&; gradually resolves (4-12 weeks)-is not modified. 3. Chancroid : erythromycin 2 g/ day for 7 days is one of the drugs of choice, as effective as azithromycin or ceftriaxone. C. As a second choice drug in 1 . Campylobacter enteritis: duration of diarrhoea and presence of organisms in stools is reduced. However, fluoroquinolones are superior. 2. Legionnaires&; pneumonia: 3 week erythromycin treatment is effective, but azithromycin/ ciprofloxacin are preferred. 3. Chlamydia trachomatis infection of urogenital tract: erythromycin 500 mg 6 hourly for 7 days is an effective alternative to single dose azithro mycin. 4. Penicillin-resistant Staphylococcal infections: its value has reduced due to emergence of erythromycin resistance as well. It is not effective against MRSA. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:728,729
Penicillin
Doxycycline
Erythromycin
Ciprofloxacin
Chemotherapy