Plasma and sputum concentrations of erythromycin were measured in 10 patients with chronic bronchitis during an eight-day course of a new formulation of erythromycin stearate. The plasma erythromycin levels compared favourably with the minimal inhibitory concentrations for common respiratory pathogens and indicated adequate gastrointestinal absorption when the drug was taken immediately before food. Sputum erythromycin levels were variable and in some patients low or undetectable. Measurable sputum erythromycin levels were approximately 10% of plasma levels with no evidence of accumulation and were of similar order of magnitude to the minimal inhibitory concentrations for common respiratory pathogens except Haemophilus influenzae. There was no correlation between sputum and plasma erythromycin levels. There was a trend for higher erythromycin levels in sputum containing increasing amounts of pus and also when plasma levels increased.
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