Erythromycin

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:

  • Acne
  • Rosacea
  • Erythrasma
  • Pityriasis lichenoids
  • Infections such as impetigo or boils.

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

It is active against many gram-positive ones. organisms (even Staphylococcus aureus, Streptococcus pyogenes, corynebacteria and clostridia) and some gram-negative organisms (Neisseria gonorrhoeae, the cause of gonorrhea). It is also effective for mycoplasma, syphilis, and chlamydia infections.

Growing bacterial Erythromycin resistance is reported. Long-term use of erythromycin has been questioned in dermatology because it can lead to bacterial resistance to pathogen, Staphylococcus aureus (See MRSA), as well as acne resistance bacteria (Cutibacterium acnes)

How does erythromycin work in skin diseases?

  • Erythromycin has bacteriostatic effects and prevents proliferation bacteria
  • Inhibits the pro-inflammatory cytokines as IL-8 and decreases neutrophils oxidative explosions

How is erythromycin taken?

Oral erythromycin is best taken on an empty stomach or just before meals. It comes in a number of bases and formulations.

  • Base compound
  • Salt stolate
  • Ethyl succinate salt
  • Stearate salt

Also available as current acne prep.To reduce antibiotic resistance, a non-antibiotic compound such as benzoyl peroxide or a topical retinoid should be applied when topical erythromycin is used.

What are the side effects of erythromycin?

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

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The following side effects can arise.

  • Gastrointestinal disorders: nausea, vomiting, abdominal pain, diarrhea, loss of appetite.
  • Hepatic reactions: more common in people with pre-existing and potentially serious liver disease. The signs are dark urine, light stools, yellow eyes and skin (jaundice)
  • Allergic rashes: urticaria, fixed drug eruptionStevens-Johnson–toxic epidermal necrolysis and rarely, anaphylaxis
  • Hearing loss - more likely with high doses in people with kidney disease
  • Potentially deadly arrhythmias (irregularities of the heartbeat) have been reported in people with dysfunction that results in a prolonged QT interval on the electrocardiograph (ECG). This may be due to congenital or acquired heart conditions or electrolyte disturbances (low levels of potassium or magnesium)

Drug interactions with erythromycin

Erythromycin has significant interactions with other medications. Tell your doctor the names of all the medications you are taking, whether prescription or over-the-counter.

  • Erythromycin should not be taken with terfenadine, astemizole, or cisapride because it could cause dangerous irregularities in the heartbeat and sudden death. These drugs are no longer available in New Zealand.
  • Other medications that can prolong the QT interval include amiodarone, risperidone, haloperidol, citalopram, and ciprofloxacin.

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

  • Warfarin (additional blood tests are needed for prothrombin time)
  • Statins, particularly simvastatin and atorvastatin. Toxicity causes muscle pain and weakness, which can be serious. If long-term treatment with a statin and erythromycin is required, suitable alternatives are fluvastatin, pravastatin, and rosuvastatin.
  • Caffeine
  • Theophylline
  • Carbamazepine
  • Cyclosporine

  • Ergotamine (increases peripheral ischemia)
  • Digoxin
  • Triazolam
  • Midazolam
  • Alfentanil
  • Pimozide
  • Bromocryptin
  • Disopyramide
  • Phenytoin
  • Valproate
  • Tacrolimus

  • Quinidine
New Zealand approved data sheets are the official source of information for these prescription drugs, including approved uses and risk information. See the New Zealand individual data sheet on the Medsafe website.