Erythromycin. New indications and toxicities.

Although erythromycin was introduced into clinical medicine more than 28 years ago, the indications for its use continue to expand. This antibiotic has emerged as appropriate therapy for Legionnaires' disease, chronic bacterial prostatitis caused by Escherichia coli, Klebsiella pneumoniae, and Proteus species, enteritis and colitis produced by Campylobacter fetus, and soft tissue and pleuropulmonary anaerobic infections in which Bacteroides fragilis plays no role. In combination with an aminoglycoside, erythromycin has proven to be effective for perioperative antibiotic prophylaxis in patients undergoing elective colon surgery. Additional therapeutic indications continue to be explored. The renewed interest in erythromycin has resulted in a closer examination of its potential for toxicity. New untoward events attributed to erythromycin administration have been described. This antibiotic has produced both reversible hearing loss and pseudomembranous colitis. Erythromycin also possesses the ability to inhibit the degradation of theophylline.