patients are intolerant to some marcrolides when taken orally. In these cases,
enteric-coated or delayed-release capsules are appropriate to prescribe.
If marcolides are administered IV, they must be diluted in 100 to 200 mL of
0.9% NS solution or 5% dextrose solution (D5W) and infused over a period of
20 to 60 minutes.
The patient should be provided with the same instructions as those given to a
patient who is receiving penicillin (see Penicillin and Patient Education).
CHAPTER 13 Antimicrobials—Fighting Infection^223
Macrolide Antibiotics
Pregnancy Category: B
Route Dose Time
Erythromycin (E-Mycin, Erythrocin, Erythrocin
Lactobionate)
Protein-Binding: 65%
Half-Life: PO 1–2 hours; IV 3–5 hours
PO 250–500 mg Every 6 hours
IV 1–4 g/d Divided doses
Azithromyzin (Zithromax)
Protein-Binding: 50%
Half-Life: 11–55 hours
PO 500 mg First Day
250 mg Daily thereafter
Clarithromycin (Biaxin)
Protein-Binding: 65%–75%
Half-Life: 3–6 hours
Pregnancy Category: C
PO 250–500 mg Every 12 hours
Erythromycin, dirithromycin (Dynabac)
Protein-Binding: Unknown
Half-Life: 20–50 hours
Pregnancy Category: C
PO 250 mg (Erythromycin) Every 6 hours
500 mg (dirithromycin) Once a day
IV 250–500 mg Every 6 hours