Erythromycin Ethylsuccinate and Sulfisoxazole (Pediazole)

Category:

• Antibiotic

Description:

• Combination antibiotic (sulfonamide and macrolide)

Indications:

• Acute otitis media (children) (H. influenzae)

Contraindications:

• Hypersensitivity to sulfa-related medications (sulfonylureas, thiazide and loop diuretics, carbonic anhydrase inhibitors, sunscreens with PABA, local anesthetics)

• Pregnancy at term

• Lactation

• Infants less than 2 months old (except congenital toxoplasmosis as adjunct with pyrimethamine)

Precautions:

• Pregnancy category C

• Sulfonamides have been associated with severe hypersensitivity reactions and death.

• Serious blood disorders (agranulocytosis, hepatocellular necrosis, aplastic anemia) have been associated with sulfonamides.  Perform complete blood counts.  Symptoms of sore throat, fever, pallor, purpura or jaundice may be early signs of serious blood disorders.

• Use with caution in patients with severe asthma or allergies.

• Hemolytic anemia may occur in patients with G-6-PD deficiency.

• Photosensitization may occur, caution patients to use protective measures against ultraviolet or sunlight until tolerance is determined.

• Sulfonamides increase the effect of oral anticoagulants (warfarin).

• Take with a full glass of water and increase fluid intake to 2-3 liters per day.

• Complete full course of therapy.

• For oral suspension; store in refrigerator, shake well before using, expiration 10 days.

• May be administered without regard to meals.

Adverse Reactions (Side Effects):

• Headache, peripheral neuropathy, depression

• Tinnitis, vertigo

• Nausea, emesis, abdominal pain, anorexia, diarrhea

• Hepatitis, pancreatitis, stomatitis

• Urticaria, Stevens-Johnson type erythema multiforme

• Crystalluria, elevated creatinine

• Drug fever, chills

• Photosensitivity

Dosage:

Administered orally (suspension)

• Acute otitis media:

• Children (> 2months): 

  • 50mg/kg/day of erythromycin and 150mg/kg/day sulfisoxizole (up to 6 grams per day) in equally divided doses 4 times a day for 10 days