During prolonged or repeated therapy, there is a possibility of overgrowth of nonsusceptible bacteria or fungi. If such infections arise, the drug should be discontinued and appropriate therapy instituted.
Mild allergic reactions such as urticaria and other skin rashes have occurred. Serious allergic reactions, including anaphylaxis, have been reported.
There have been isolated reports of hearing loss and/or tinnitus in patients receiving erythromycin. The ototoxic effect of the drug is usually reversible with drug discontinuance; however, in rare instances involving intravenous administration, the ototoxic effect has been irreversible. Ototoxic effects occur chiefly in patients with renal or hepatic insufficiency and in patients receiving high doses of erythromycin.
Very rarely erythromycin has been associated with QT prolongation and ventricular arrhythmias, including ventricular tachycardia and torsades de pointes.
Several reports of infantile hypertrophic pyloric stenosis have been reported in newborn infants receiving various erythromycin products, including erythromycin estolate. Erythromycin should be used cautiously in the first three months of life.
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