Erythromycin is a long established alternative to penicillins in the treatment of bacterial throat infection, in pneumococcal pneumonia and in streptococcal or staphylococcal infection of the skin or soft tissues. It is the first choice in pneumonias due to Mycoplasma pneumoniae, legionella and respiratory chlamydia. Erythromycin generally has to be given four times daily, and unwanted effects, particularly nausea, abdominal pain and vomiting, are common. Low activity against Haemophilus influenzae is a further drawback. Two new macrolide antibiotics, clarithromycin and azithromycin, seem to have possible advantages over erythromycin.
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