Adverse effects

Most side-effects are gastrointestinal. Erythromycin in particular can cause nausea and vomiting in some patients. Clarithromycin and azithromycin are tolerated better, and are good alternatives in patients who are intolerant of erythromycin. Some patients are allergic to macrolides, and a hypersensitivity to one macrolide confers cross-class allergy. Erythromycin has also been known to cause reversible hearing loss. Erythromycin is safe to use in pregnancy and lactation. Azithromycin is not licensed in the UK for use in pregnancy; however, some GUM centres use it in pregnancy following a detailed discussion with the mother-to-be.

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