All Antimicrobial's should be prescribed according to Trust antimicrobial policy or on the advice of a microbiologist. Restricted antimicrobials should be prescribed for the use or department specified unless on advice of the microbiologist. Please note some non formulary items maybe prescribed on strict advice of the microbiology team direction only.
Where antimicrobials are listed in the NICE/PHE Summary of antimicrobial prescribing guidance and this guidance is agreed locally, that those antibiotics are considered on formulary when prescribed in line with the guidance
Drug Safety Update
December 2020: Erythromycin: caution required due to cardiac risks (QT interval prolongation); drug interaction with rivaroxaban
December 2020: Erythromycin: update on known risk of infantile hypertrophic pyloric stenosis
Prescribing Notes
Drug interactions
Erythromycin and clarithromycin are enzyme inhibitors and will interact with drugs that are metabolised by the same pathways. Most important of these interactions are with theophylline, phenytoin and carbamazepine, due to the narrow therapeutic index of these drugs. There is an increased risk of myopathy when prescribed with simvastatin. It is is advised to avoid concomitant use and simvastatin is stopped whilst taking the antibiotic. Check the BNF for a full list of interactions.
