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To the Editor.—
The recent article in The Journal demonstrating the effectiveness of erythromycin estolate for streptococcal pharyngitis (226:531, 1973) failed to mention the hazard of using this drug. The 1973 edition of AMA Drug Evaluations on page 530 clearly states, "Erythromycin estolate, the lauryl sulfate salt of the propionyl ester of erythromycin, is the only erythromysin ester associated with hepatotoxicity. It can produce jaundice."In my estimation, this well-known fact precludes the use of the estolate under many circumstances, since there are many other erythromycin salts that are not hepatotoxic. The estolate form has no outstanding advantages over the other esters. In my judgment, the Food and Drug Administration should ban this drug.
Levenson D. Erythromycin Estolate. JAMA. 1974;227(2):204–205. doi:10.1001/jama.1974.03230150052031