Authors: Latest update by A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, December 2017.
Erythromycin is a macrolide antibiotic. Other macrolide antibiotics include azithromycin, clarithromycin, roxithromycin.
Erythromycin is prescribed by dermatologists for a variety of skin conditions including:
It is active against many gram-positive organisms (including Staphylococcus aureus, Streptococcus pyogenes, corynebacteria and clostridia) and some gram-negative organisms (Neisseria gonorrhoeae, the cause of gonorrhoea). It is also effective for mycoplasma infections, syphilis and chlamydia.
Increasing bacterial resistance to erythromycin is reported. The prolonged use of erythromycin has been questioned in dermatology because it can lead to bacterial resistance to the pathogen, Staphylococcus aureus (see MRSA), as well as resistance to acne bacteria (Cutibacterium acnes).
Oral erythromycin is best-taken fasting or just before meals. It comes in a number of bases and formulations.
It is also available as a topical preparation for acne. To reduce antibiotic resistance, a non-antibiotic compound such as benzoyl peroxide or a topical retinoid should be applied when using topical erythromycin.
Erythromycin is generally well tolerated. When essential, erythromycin can be used in pregnancy and during breastfeeding.
The following side effects may arise.
Erythromycin has important interactions with other medications. Tell your doctor the names of all medications you are taking, whether prescribed or purchased without a prescription.
Erythromycin can increase the concentration of the following medications resulting in potentially toxic levels.
Adler BL, Kornmehl H, Armstrong AW. Antibiotic Resistance in Acne Treatment. JAMA Dermatol 2017 Jun 21;[EPub Ahead of Print]. PubMed.
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