Erythromycin breath test

The erythromycin breath test (ERMBT) is a method used to measure metabolism (oxidation and elimination from the system) by a part of the cytochrome P450 system.[1] Erythromycin produces 14CO2, and this 14CO2 can be measured to study drugs that interact with the cytochrome P450 system. [2] Erythromycin is tagged with carbon-14 and given as an intravenous injection; after 20 minutes the subject blows up a balloon and the carbon dioxide exhaled that is tagged with carbon-14 shows the activity of the CYP3A4 isoenzyme on the erythromycin. ERMBT can be used to determine how drugs that the CYP3A4 isoenzyme metabolizes will function in a given individual.

Erythromycin breath test
Purposemeasure oxidation and elimination from the system

Erythromycin is a drug that treats bacterial infections like bronchitis, sexually transmitted diseases, and pneumonia. The medication is in a capsule form and takes on a "delayed-release," to ensure it is only broken down once it reaches the intestine and not by stomach acids.[3]

The test allows doctors to determine or predict an individual’s drug treatment outcome. Will a patient develop serious or fatal side effects from a certain drug? Which foods and drugs should not be taken together? With this and other tests a physician may determine treatment outcomes in advance or study the effects of new drugs.[1]

Some patients have a congenital inability to synthesize certain enzymes, so drugs may build up to toxic levels in their system or other drugs and foods a patient is taking may consume all of their ability to metabolize certain foods and drugs. An example is: when a person taking a cholesterol-lowering statin drug then drinking grapefruit juice, they may have a poor treatment outcome (adverse drug reaction) and sustain liver damage or kidney failure due to drug induced rhabdomyolysis (the breaking up of muscle tissue).[4]

References
  1. Zhou S, Chan E, Lim LY, et al. (October 2004). "Therapeutic drugs that behave as mechanism-based inhibitors of cytochrome P450 3A4". Curr. Drug Metab. 5 (5): 415–42. doi:10.2174/1389200043335450. PMID 15544435.
  2. Chhun, Stephanie (2009). "Gefitinib-phenytoin interaction is not correlated with the 14 C-erythromycin breath test in healthy male volunteers". British Journal of Clinical Pharmacology. 68 (2): 226–237. doi:10.1111/j.1365-2125.2009.03438.x. PMC 2767287. PMID 19694743.
  3. "Erythromycin: MedlinePlus Drug Information". medlineplus.gov. Retrieved 2022-05-08.
  4. Lee, Jonathan W.; Morris, Joan K.; Wald, Nicholas J. (2016-01-01). "Grapefruit Juice and Statins". The American Journal of Medicine. 129 (1): 26–29. doi:10.1016/j.amjmed.2015.07.036. ISSN 0002-9343. PMID 26299317.


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