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Most of erythromycin is metabolised by demethylation in the liver by the hepatic enzyme CYP3A4. Its main elimination route is in the bile with little renal excretion, 2%–15% unchanged drug. Erythromycin's elimination half-life ranges between 1.5 and 2.0 hours and is between 5 and 6 hours in patients with end-stage renal disease.
The erythromycin breath test has numerous clinical applications, particularly in transplantation and pharmacology. It is frequently used to evaluate the activity of the CYP3A4 enzyme, which is critical in the metabolism of medications such as cyclosporine and tacrolimus in liver transplant patients.
For example, antibiotics that kill gut bacteria often reduce enterohepatic drug circulation and this requires a temporary increase of the drug's dose until the antibiotic use is discontinued and the gut repopulates with bacteria. This effect of antibiotics on enterohepatic circulation of other drugs is one of several types of drug interactions.
Macrolides, mainly erythromycin and clarithromycin, also have a class effect of QT prolongation, which can lead to torsades de pointes. Macrolides exhibit enterohepatic recycling; that is, the drug is absorbed in the gut and sent to the liver, only to be excreted into the duodenum in bile from the liver. This can lead to a buildup of the ...
Antibiotic candidates Generic name Origin Susceptible phyla Stage of development Mechanism of action Unclassified Teixobactin: Eleftheria terrae: Gram-positive, including antibiotic resistant S. aureus and M. tuberculosis: No human trials scheduled: Binds fatty acid precursors to cell wall Malacidins: Uncultured Bacterium
Potential risks: Some negative side effects like muscle cramps, facial swelling, and bloating have been reported in relation to medication interactions, as well as for some people with existing ...
Additional side effects can result from interaction with other drugs, such as the possibility of tendon damage from the administration of a quinolone antibiotic with a systemic corticosteroid. [51] Some antibiotics may also damage the mitochondrion, a bacteria-derived organelle found in eukaryotic, including human, cells. [52]
"Hopefully, we can continue to get in people's living rooms and entertain them the way we have over the last seven years," he says of the future of the Dutton universe
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