1. Identify allergy to any antibiotics; note allergens.

2. Document type, onset, and characteristics of symptoms, other agents used, and the outcome.

3. Avoid if also prescribed astemi-

zole, Seldane, digoxin, and theo-phyllines, because erythromycins can inhibit cytochrome P-450 and enhance effects of these drugs or cause lethal arrhythmias. Client/Family Teaching

1. Do not administer with or immediately prior to ingestion of fruit juice or other acidic drinks; acidity may decrease drug activity. Consume up to 8 oz of water with each dose and a fluid intake of 2.5 L/day.

2. May take with food to diminish GI upset; however, food decreases the absorption of most erythromy-cins. Take only as directed and complete entire prescription despite feeling better.

3. If tablets are not coated, take them 2 hr after meals. Stomach acid destroys the erythromycin base thus it must be administered with an enteric coating.

4. Doses of erythromycins should be evenly spaced throughout a 24-hr period.

5. If nausea is intolerable, notify provider so the prescription can be changed to coated tablets that can be taken with meals.

6. Report symptoms of superinfection, i.e., furry tongue, vaginal itching, rectal itching, or diarrhea.

7. Any rash, yellow discoloration of skin or eyes, or irritation of the mouth or tongue should be reported.

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