The ester of erythromycin classically associated with intrahepatic cholestasis when used in pregnant women is:
- A Erythromycin estolate ✓
- B Erythromycin stearate
- C Erythromycin succinate
- D Erythromycin base
Correct answer: A. Erythromycin estolate
Explanation
Erythromycin estolate, the lauryl sulfate ester, is the formulation classically linked to reversible cholestatic hepatitis, presenting with right upper quadrant pain, fever and jaundice mimicking acute cholecystitis. The risk is highest in pregnant women receiving more than two weeks of therapy. Other salts such as the stearate, ethylsuccinate and free base carry a much lower risk, so alternatives like azithromycin are now preferred in pregnancy.
Reference: Katzung's Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.