Erythromycin breath test explained

Erythromycin breath test
Purpose:measure oxidation and elimination from the system

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. Erythromycin produces 14CO2, and this 14CO2 can be measured to study drugs that interact with the cytochrome P450 system. [1] 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 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.[2]

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.[3]

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]

Notes and References

  1. 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 . 10.1111/j.1365-2125.2009.03438.x . 19694743 . 2767287 .
  2. Web site: Erythromycin: MedlinePlus Drug Information . 2022-05-08 . medlineplus.gov . en.
  3. 15544435 . 5 . 5 . Therapeutic drugs that behave as mechanism-based inhibitors of cytochrome P450 3A4 . October 2004 . Zhou S, Chan E, Lim LY, etal . Curr. Drug Metab. . 415–42 . 10.2174/1389200043335450.
  4. Lee . Jonathan W. . Morris . Joan K. . Wald . Nicholas J. . 2016-01-01 . Grapefruit Juice and Statins . The American Journal of Medicine . English . 129 . 1 . 26–29 . 10.1016/j.amjmed.2015.07.036 . 26299317 . 0002-9343.