PEDIATRICS Vol. 49 No. 5 May 1972, pp. 784-785
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In Reply: Erythromycin in the Middle Ear: Further Information

James W. Bass M.D.1

1 Department of Pediatrics, Tripler Army Medical Center, APO San Francisco 96438

Thank you for the opportunity to respond to Dr. Meland's comments regarding our article "Erythromycin Concentrations in Middle Ear Exudates," which was published recently in the Journal.

We are aware that the various esters of erythromycin are absorbed in their bacteriologically inactive form and must be hydrolyzed to active erythromycin base in the body, a process which may take considerable periods of time with certain esters of the drug. This delay in hydrolysis of erythromycin esters to the active base observed in vivo may explain why viable Hemophilus influenzae organisms were isolated from exudates with relatively high total concentrations of erythromycin as determined by the in vitro method of bioassy utilized.