Erythromycin
| Evidence Level: L5 | Predicted Indications: 4 |
Table of Contents
Erythromycin: Punctate epithelial keratoconjunctivitis
One-Sentence Summary
Erythromycin is a macrolide antibiotic with antibacterial and anti-inflammatory properties. The TxGNN model predicts it may be useful for punctate epithelial keratoconjunctivitis, but there are currently no registered clinical trials and only 1 indirect publication (a review on chronic blepharokeratoconjunctivitis in children) behind this prediction.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | Punctate epithelial keratoconjunctivitis |
| TxGNN Prediction Score | 0.9989 |
| Evidence Level | L5 |
| Canada Market Status | Marketed (marketed DINs: 6 of 6) |
| Number of DINs | 6 (marketed: 6) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism of action data is not available in the data compiled for this report. Based on general knowledge, erythromycin is a macrolide that blocks bacterial protein synthesis and also has anti-inflammatory and immunomodulatory effects. An ophthalmic ointment containing erythromycin is among the Canadian products, so activity against the bacterial and inflammatory parts of surface eye disease is plausible.
The only supporting paper is a pediatric review of chronic blepharokeratoconjunctivitis. It is a related condition, not punctate epithelial keratoconjunctivitis itself, so the evidence is indirect. The very high score probably reflects closeness to existing eye-infection uses rather than independent proof of benefit. No study in the data directly examines this disease, so the evidence level is L5.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 11495307 | 2001 | Review | Journal of Pediatric Ophthalmology and Strabismus | Describes the history, symptoms, signs and treatment of chronic blepharokeratoconjunctivitis in children; a related but different condition |
Canada Market Information
| DIN | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 00682268 | ERYTHROCIN I.V. | Not specified | Not specified |
| 01912755 | PDP-ERYTHROMYCIN | Not specified | Not specified |
| 00682276 | ERYTHROCIN I.V. | Not specified | Not specified |
| 02141574 | ERYTHROMYCIN | Not specified | Not specified |
| 02326663 | ERYTHROMYCIN OPHTHALMIC OINTMENT USP | Not specified | Not specified |
Safety Considerations
- Contraindications / conditions of concern (listed in the data compiled for this report; these are not label text): long QT syndrome (including familial), torsades de pointes, porphyria, kidney disease, liver disease, gallbladder disease, blood disorders, exfoliative dermatitis and other dermatitis, Clostridium difficile colitis, myasthenia gravis and other neuromuscular junction disease, folic acid deficiency anemia, and hearing disorders.
- Drug Interactions: 100 interactions were found. Major ones include loperamide and clarithromycin. Moderate ones include famotidine, cimetidine, hydrocortisone, dexamethasone, budesonide, pioglitazone, aprepitant and alosetron.
Please also refer to the package insert for full safety information.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction score is very high, but no clinical trial and no study directly on punctate epithelial keratoconjunctivitis was found. The single supporting review addresses a related condition, so the evidence stays at L5.
To proceed, the following is needed:
- Studies or trials that directly evaluate erythromycin in punctate epithelial keratoconjunctivitis
- Mechanism of action data
- Package insert warnings and contraindications from Health Canada
- Approved indication text for the Canadian licences, especially the ophthalmic ointment
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.