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Oral Antibiotics - Erythromycin

Erythromycin is an antibiotic in the macrolide group and is used in acne treatment. It is the antibacterial and anti-inflammatory effects that are important. If your patient's inflamed pimples do not respond well to topical antibiotics or if they have acne on many areas of their body, acne antibiotics in pill form (oral) can be more effective, easier to take, and more convenient.

How Do Patients Use This Medication?

This antibiotic is available both as an oral and a topical acne medication.

How Does It Work?

It is a bacteriostatic antibiotic, that is, it inhibits the growth of bacteria. It may also have an anti-inflammatory effect.

It is useful in the following conditions:

  • Acne
  • Rosacea
  • Perioral dermatitis
  • Pityriasis Lichenoides et Varioliformis Acuta (PLEVA), or Mucha-Habermann disease
  • Erythrasma
  • Erysipelas
  • Erysipeloid
  • Actinomycosis
  • Amebiasis
  • Gonorrhea
  • Chancroid
  • Syphilis
  • Granuloma inguinale
  • Lymphogranuloma venereum virus

Will There Be Side Effects?

Gastrointestinal upset is common with this acne antibiotic.

Rare side effects include:

  • Live toxicity
  • Cardiac toxicity
  • Pancreatitis
  • Ototoxicity(inner ear) in those who have kidney failure
The estolate type of erythromycin should be avoided during pregnancy because there is a risk of liver toxicity.

Taking Other Medications?

Avoid astemizole (Hismanol®) and terfenadine (Seldane®, Seldane-D®), which are antihistamines, avoid cisapride (Propulsid®), which is used to treat symptoms of night time heartburn due to gastroesophageal reflux disease. Levels of the following drugs may increase if taken with erythromycin: carbamazepine, valproic acid, warfarin and theophyllin.

Which Brands Are Available?

Oral:

  • Base - ERYC, E-Mycin
  • Ethylsuccinate - EES®
  • Estolate - Ilosone® (not used in adults)
Topical:
  • A/T/S 2-3%
  • Erycette® (Ortho)
  • Erygel® (Allergan)