Erythromycin Lactobionate Injection

11 November 2009

Products Affected - Description

Reason for the Shortage

Hospira is the sole supplier of erythromycin lactobionate.  The company will not provide a reason for the shortage.¹

Estimated Resupply Dates

Hospira has the erythromycin 500 mg vials (NDC 00409-6482-01) available by direct drop shipment. The erythromycin 500 mg Add-Vantage vials are on back order with an estimated release date of January, 2010. The 1 gram Add-Vantage vials have been discontinued.¹

Implications for Patient Care

• Erythromycin lactobionate injection is labeled for the treatment of respiratory tract infections caused by susceptible strains of Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae (in combination with sulfonamides), Mycoplasma pneumoniae; skin and skin structure infections caused by Streptococcus pyogenes and Staphylococcus aureus; Diphtheria; erythrasma due to infections caused by Corynebacterium minutissimum; and pelvic inflammatory disease caused by Neisseria gonorrhoeae for patients with penicillin allergy.²
• Erythromycin lactobionate injection is also used as a promotility agent in patients with gastroparesis;^3,4 and as an alternative for penicillin-allergic patients for the prevention of perinatal Group B Streptococcal disease.⁵

Alternative Agents & Management

• Oral erythromycin therapy may be an option for some patients. 
• The Table provides alternatives for selected situations.

Related Shortages

• Aztreonam Injection
• Carbenicillin Indanyl Capsules— No Longer Available
• Cefaclor
• Cefazolin Injection— Resolved
• Cefepime Injection— Resolved
• Cefotetan Disodium— Resolved
• Cefotetan Injection— Resolved
• Cefoxitin Injection— Resolved
• Ceftizoxime Injection— Resolved
• Cefuroxime Injection— Resolved
• Ciprofloxacin Immediate-Release Tablets
• Doxycycline Hyclate Injection
• Erythromycin Ophthalmic Ointment
• Imipenem and Cilastatin Injection— Resolved
• Kanamycin— Resolved
• Kanamycin Sulfate Injection
• Loracarbef Oral Tablets and Suspension— No Longer Available
• Minocycline Injection— No Longer Available
• Nafcillin Injection— Resolved
• Oxacillin Injection— Resolved
• Penicillin G Benzathine Injection— Resolved
• Penicillin G Procaine Suspension for Injection— Resolved
• Piperacillin and Tazobactam Injection— Resolved
• Polymyxin B Injection— Resolved
• Ticarcillin and Clavulanate Injection— Resolved
• Tigecycline Injection— Resolved
• Tobramycin Powder for Injection
• Vancomycin Hydrochloride Injection

1. Hospira (personal communications) June 26 and 29, August 18 and 28, September 14, October 2, and November 11, 2009.
2. Erythrocin Lactobionate - IV [product information]. Lake Forest, IL: Hospira, Inc.; 2006.
3. Prakash C. Gastrointestinal Diseases. In: Cooper DH, Krainik AJ, Lubner SJ, Reno HEL, eds. The Washington Manual of Medical Therapeutics. 32th ed. Philadelphia, PA: Lippincott-Williams & Wilkins; 2007;439-472.
4. McQuaid KR. Drugs Used in the Treatment of Gastrointestinal Diseases. In: Katzung BG, Masters SB, Trevor AJ: Basic and Clinical Pharmacology, 11th Edition, 2009 (accessed on June 29, 2009).
5. Centers for Disease Control and Prevention. Prevention of Perinatal Group B Streptococcal Disease. MMWR. 2002;51(RR-11):1-22.
6. Food and Drug Administration. MedWatch Alert – Metoclopramide-Containing Drugs. February 26, 2009. Accessed on June 29.
7. Metoclopramide. In: Lacy CF, Armstrong LL, Goldman P, Lance LL, eds. The Drug Information Handbook. 2008 – 2009. Hudson, OH: Lexicomp; 2009:1024-1025.
8. Entereg (alvimopan) capsules [product information]. Research Triangle Park, NC: GlaxoSmithKline;2008.
9. ACOG Practice Bulletin No. 80: premature rupture of membranes. Clinical management guidelines for obstetrician-gynecologists. Obstet Gynecol. Apr 2007;109(4):1007-1019.
10. Mercer BM. Preterm premature rupture of the membranes: diagnosis and management. Clin Perinatol. Dec 2004;31(4):765-782, vi.
11. Mercer BM, Miodovnik M, Thurnau GR, et al. Antibiotic therapy for reduction of infant morbidity after preterm premature rupture of the membranes. A randomized controlled trial. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Jama. Sep 24 1997;278(12):989-995.
12. Giorlandino C, Cignini P, Cini M, et al. Antibiotic prophylaxis before second-trimester genetic amniocentesis (APGA): a single-centre open randomised controlled trial. Prenat Diagn. Jun 2009;29(6):606-612.

Updated

Updated November 11, 2009, by Michelle Wheeler, Pharm.D., Drug Information Specialist. Created September 3, 2003 by M. Christina Beckwith, Pharm.D., and Erin R. Fox, Pharm.D., Drug Information Specialists. Copyright 2009, Drug Information Service, University of Utah, Salt Lake City, UT.

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