Erythromycin

Authors: Latest update by A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, December 2017.

What is erythromycin?

Erythromycin is a macrolide antibiotic. Other macrolide antibiotics include azithromycin, clarithromycin, roxithromycin.

What is erythromycin used for?

Erythromycin is prescribed by dermatologists for a variety of skin conditions including:

Erythromycin is particularly useful in individuals allergic to penicillin and in children that are too young for a tetracycline.

It is active against many gram-positive organisms (including Staphylococcus aureus, Streptococcus pyogenes, corynebacteria and clostridia) and some gram-negative organisms (Neisseria gonorrhoeae,). 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 pathogenStaphylococcus aureus (see MRSA), as well as resistance to acne bacteria (C acnes).

How does erythromycin work in skin diseases?

How is erythromycin taken?

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.

Side effects of erythromycin

Erythromycin is generally well tolerated. When essential, erythromycin can be used in pregnancy and during breast feeding.

The following side effects may arise.

Drug interactions with erythromycin

Erythromycin has important interactions with other medications. Tell your doctor the names of all medications you are taking, whether prescribed or purchased without prescription.

Erythromycin can increase the concentration of the following medications resulting in potentially toxic levels.

New Zealand approved datasheets are the official source of information for these prescription medicines, including approved uses and risk information. Check the individual New Zealand datasheet on the Medsafe website.

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