We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Erythromycin Ethylsuccinate Hepatotoxicity

David Sullivan, MD; Mary Ellen Csuka, MD; Bradford Blanchard, MD
JAMA. 1980;243(10):1074. doi:10.1001/jama.1980.03300360046027.
Text Size: A A A
Published online


ERYTHROMYCIN is available to the clinician in several forms, each of which differs primarily because of a single substitution at the two-prime position of the desoamine moiety. All commonly available forms can be associated with mild abdominal cramping, nausea and vomiting, diarrhea, and hypersensitivity reactions. Hepatotoxicity presenting dramatically with fever and abdominal pain suggesting an acute surgical abdomen has been associated only with the estolate form of the antibiotic. The following case illustrates a similar syndrome related to the ethylsuccinate preparations.1

Report of a Case  A 45-year-old woman was given erythromycin ethylsuccinate (EES-400), 400 mg orally four times daily, after two weeks of rhinitis and productive cough. On the ninth day of therapy, the patient had sudden onset of severe right upper quadrant pain, fever (temperature, 40 °C), shaking chills, nausea, and vomiting. Erythromycin administration was discontinued. As the acute symptoms lessened over the next 24 hours, dark urine


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.