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tetracycline and oleandomycin

J01RA08

Forms & Strengths

Oral capsules containing tetracycline hydrochloride and oleandomycin triacetate in fixed combinations (historically available, largely obsolete)
Combination ratios typically 2:1 or 1:1

Adult Dosing

Historically 250 mg to 500 mg (combined active ingredients) orally every 6 hours for susceptible infections
Dose adjusted based on severity of infection and specific pathogen

Pediatric Dosing

Not recommended in pediatric patients under 8 years of age due to tetracycline component (risk of permanent tooth discoloration and enamel hypoplasia)
Older children: dosage calculated based on weight and severity, typically 6.25 to 12.5 mg/kg every 6 hours

Indications

Historically used for mixed bacterial infections sensitive to both tetracycline and oleandomycin
Upper and lower respiratory tract infections
Skin and soft tissue infections

Mechanism of Action

Synergistic or additive bacteriostatic effect via dual inhibition of bacterial protein synthesis
Tetracycline binds to the 30S ribosomal subunit, preventing access of aminoacyl-tRNA
Oleandomycin (a macrolide) binds to the 50S ribosomal subunit, inhibiting translocation

Contraindications

Hypersensitivity to tetracyclines or macrolides (including oleandomycin, erythromycin)
Pregnancy and lactation
Children under 8 years of age
Severe hepatic impairment

Adverse Reactions

Gastrointestinal distress: nausea, vomiting, diarrhea, pseudomembranous colitis
Hepatotoxicity, elevated liver enzymes, jaundice
Hypersensitivity reactions: rash, urticaria, anaphylaxis
Photosensitivity and permanent tooth discoloration in children

Drug Interactions

Antacids, iron preparations, and divalent/trivalent cations decrease absorption of tetracycline
May decrease the efficacy of oral contraceptives
Potential for antagonism when combined with bactericidal antibiotics like penicillins
May enhance the anticoagulant effect of warfarin

Curated Content: Needs Vetting Before Put to Clinical Use