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  • Erythromycin

    Summary

    Erythromycin is an antibiotic. Antibiotics work by suppressing the growth of bacteria that contribute to acne symptoms.

    Erythromycin is available in Oral and Topical formulations. Topical antibiotics can be used to treat all types of acne, while oral antibiotics are usually reserved for patients with serious symptoms.

    Overall, Erythromycin is rated as a Mediocre treatment for acne. Users report that, Erythromycin is Somewhat Effective for improving acne symptoms and that this medication tends to have Mild side effects.

    Ratings Breakdown

    Erythromycin RatingsScore
    Overall3.1
    Effectiveness3
    Side Effects2.19
    User Recommended40.74%
    Antibiotic Susceptibility3.64
    Antibiotic Resistance2.95
    Editor Rating3.00
    Table Key: Green is Good, Red is Bad

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    The Basics

    Type of Treatment: Rx MedicationAntibiotic (Oral and Topical) - Macrolide Family

    How It Works: Erythromycin is an antibiotic. Antibiotics can improve acne symptoms by limiting the growth of bacteria that contribute to Acne Vulgaris.

    When is this medication used? Erythromycin is is used for the treatment of all types of acne, from very mild to severe (Acne Types: 1-4).  In cases of moderate to severe acne (Acne Types: 3-4), erythromycin is often combined with complementary treatments.

    Frequency of Erythromycin Resistant P. acnes Bacteria: Common. (What does this mean?)

    Official Name: Erythromycin
    Popular Brand Names: Aknemycin, E-Mycin, Benzamycin (erythromycin and Benzoyl Peroxide), Stiemycin and Eryacne.
    Related Medications: Azithromycin, Clarithromycin, Roxithromycin, Tylosin, Clindamycin.

    Important Note: The information provided on this site is intended for informational purposes only and is not intended to diagnose or treat any diseases. The Science of Acne strongly encourages you to consult a qualified medical professional before making any treatment decisions. For the complete disclaimer, click here.

    Erythromycin and Acne

    Erythromycin is one of the most commonly used topical antibiotics for the treatment of acne symptoms.  It is often used alone, or in a combination with benzoyl peroxide (Benzamycin) or with sulfisoxazole (Sulfimycin).  Oral erythromycin is also used for acne, but is much less common  than topical forms of the medication.

    When used in patients with erythromycin-susceptible Propionibacterium acnes infections, both the oral and topical from of this medication can be effective for improving acne symptoms.  The major limitation to the use of erythromycin with acne vulgaris is the increasing frequency of antibiotic resistant bacteria.  Recent analyses of P. acnes samples taken from acne patients in the United States and Europe suggest that the majority of these infections are now resistant to macrolide antibiotics (including erythromycin, clarithromycin, azithromycin) and other closely related antibiotics (clindamycin).  The frequency of antibiotic resistance in acne vulgaris is much higher in developed countries (eg. USA, Italy), and is less of a problem in the developing world (eg. Peru, Mexico).

    Like most other topical treatments, topical erythromycin is often a poor treatment for severe and/or inflammatory acne.  Erythromycin is a large molecule that does not penetrate deeply into the skin when applied topically.  Even when effective, topical erythromycin treatment improves acne symptoms, but rarely leads to complete clearance of acne lesions.

    Patient Reviews of Erythromycin

    Topical erythromycin is a medication that is commonly used to treat acne vulgaris.  Topical erythromycin is generally well reviewed by acne patients.  Oral erythromycin is rarely used for the treatment of acne.

    Topical erythromycin can be very effective against mild to moderate acne (Acne Types: 1-2).  However, bacterial resistance to erythromycin is common, and increasing.  Erythromycin-resistant P. acnes bacteria are frequently isolated from the pimples of acne patients. Topical erythromycin is generally not completely effective as monotherapy (used alone) against moderate to severe inflammatory acne (Acne Types: 3-4).

    Additional Patient Reviews of erythromycin: Acne.org,  WebMD Drugs.com, DailyStrength.org, EveryDayHealth.com, DrugLib.com and RXList.com.

    Cost and Availability of Erythromycin

    If possible, erythromycin should be obtained through consultation of a qualified medical professional.  Many doctors and dermatoloigsts are familiar with this medication and commonly prescribe topical erythromycin for acne vulgaris.  Oral erythromycin is less commonly used.   Erythromycin is available in both generic and brand name formulations. Generic erythromycin tends to be inexpensive to moderately expensive when compared to other commonly used antibiotics. Brand name erythromycin and proprietary combinations of erythromycin with other medications tend to be moderately to very expensive.

    Important Note: The information provided above is not intended as a recommendation or endorsement. The Science of Acne encourages you to adhere to all applicable legal regulations in your jurisdiction. Before ordering pharmaceutical medications online, please read our overview: A Guide to Buying Prescription Medications on the Internet.

    Side Effects of Erythromycin

    Like most other antibiotics, the most common side effects of erythromycin treatment are related to gastro-intestinal problems and allergic reactions.  Common symptoms of allergic reactions include skin rashes, hives, fever, joint pain, headaches and nausea.  More severe allergic reactions can include urticaria, anaphylaxis and Stevens-Johnson syndrome.  Topical erythromycin has a much lower incidence of adverse reaction than oral erythromycin.  Oral erythromycin is more likely than other antibiotics to cause diarrhea because it activates a signalling molecule called motilin, which stimulates gastric activity.

    Because of the increased risk of side effects, oral erythromycin is not often be prescribed as a first choice antibiotic, if suitable alternatives are available.   The use of erythromycin is generally avoided in pregnant women.  Erythromycin may also decrease the effectiveness of oral contraceptives.  There are several drugs whose use is contraindicated with oral erythromycin.

    For more in-depth information about potential side effects of erythromycin treatment, refer to the physician’s insert for erythromycin, or consult a medical professional.  For more information about contraindications in general, refer to Avoiding Negative Drug Interactions.

    Erythromycin Background

    Erythromycin (Eryacne, E-Mycin) Molecule

    Erythromycin (E-mycin) is an antibiotic in the macrolide family. Erythromycin kills bacteria by inhibiting their ability to synthesize new proteins. It has a similar mechanism of action and range of activity as other macrolide family antibiotics (eg. azithromycin and clarithromycin).

    Erythromycin is sometimes used as an alternative to penicillin family antibiotics, particularly in individuals with penicillin allergies. Erythromycin is one of the more complex antibiotics and is fairly difficult to synthesize. As a result, the cost of this medication tends to be high compared to other antibiotics. Erythromycin has a relatively short half life in the body (1.5 hours) which may require more frequent doses, or the use of extended release forms of the medication.

    In addition it’s use in the treatment of acne vulgaris, erythromycin is used for a number of other types of infection including: Respiratory tract infections, diphtheria, Legionnaires’ disease, rheumatic fever, urinary tract infections and others.

    Additional Names for Erythromycin: A/T/S, Abboticin, Acnasol, Acnederm, Acne Hermal, Acneryne, Acnetrim, Akne-Mycin, Aknederm, Aknefug, Aknilox, Althrocin, Benzamycin (with benzoyl peroxide), Clarex, Clinac, Dankit, Davercin, Deripil, Dermamycin, E-Base, E-Glades, E-Solve 2, E.E.S., EES, Egéry, Elislit, Emcin Clear, Emgel, Eridosis, Eritax, Erithromycin, Eritrocina, Eritroderm, Eritromicin, Eritromicina, Eromycin, Ery, Ery Pads, Ery-Sol, Ery-Tab, Eryacnen, Eryaknen, Eryc, Erycette, Erycin, Erycreat, Eryderm, Erydermec, Erydiolan, Eryfluid, Erygel, Eryhexal, Erymax, Erymed, Erythra-Derm, Erythro, Erythrocin, Erythrocot, Erythrogel, Erythromil, Erythromycine, Erythromycini, Erythromycinum, Erythropen, Érythromycine, Erytrodol, Erytromycine, Escumycin, Etromycin, Euskin, Hexabotin, Ilosone, Iloticina, Ilotycin, Inderm, Lagarmicin, Lauromicina, Meromycin, Monomycin, MY-E, Pantomicina, Pediamycin, Propionylerythromycin, Robimycin, Romycin, Rythinate, Sansac, Sansacné, Septix, Staticin, Stiemycine, Stimycine, T-Stat, Theramycin Z, Tiloryth and Zineryt.

    Related Articles from The Science of Acne

    Erythromycin Patient Reviews (Comprehensive)
    Overview: Avoiding Negative Drug Interactions
    A Guide to Buying Prescription Medications on the Internet
    Overview: Prescription Medications Used in Acne Treatment
    In Depth: Antibiotic Susceptibility of Propionibacterium acnes

    References and Sources

    Books

    PDR Staff Writers. 2011. 2011 Physicians’ Desk Reference
    Gallagher. 2011. Antibiotics Simplified, Second Edition
    Habif. 2009. Clinical Dermatology
    Goodheart. 2006. Acne For Dummies
    Bartlett. 2012. Johns Hopkins Antibiotics Guide 2012 (Johns Hopkins Medicine)

    Online Resources

    Erythromycin @ PubMed Health - The National Institute of Health (US) offers basic comprehensive information about most common medications.
    Erythromycin @ Wikipedia - Wikipedia is an excellent resource for learning about how medications work.
    Erythromycin Physician’s Insert - The physician’s insert for a medication contains nearly all of the relevant information, including indications, dosage information and background data.

    Scientific Research Articles

    Gammon, et al. 1986. Comparative efficacy of oral erythromycin versus oral tetracycline in the treatment of acne vulgaris. A double-blind study.
    Eady, et al. 2006. Erythromycin resistant propionibacteria in antibiotic treated acne patients: association with therapeutic failure.
    Burke, et al. 2006. Benzoylperoxide versus topical erythromycin in the treatment of acne vulgaris.
    Chalker, et al. 1983. A double-blind study of the effectiveness of a 3% erythromycin and 5% benzoyl peroxide combination in the treatment of acne vulgaris.
    Habbema, et al. 2006. A 4% erythromycin and zinc combination (Zineryt®) versus 2% erythromycin (Eryderm®) in acne vulgaris: a randomized, double-blind comparative study.
    Korting, et al. 1989. Efficacy and tolerability of combined topical treatment of acne vulgaris with tretinoin and erythromycin in general practice.
    Lesher, et al. 1985. An evaluation of a 2% erythromycin ointment in the topical therapy of acne vulgaris.
    Eady, et al. 2008. The effects of acne treatment with a combination of benzoyl peroxide and erythromycin on skin carriage of erythromycin resistant propionibacteria.
    Gupta, et al. 2003. A Randomized, Double-Blind, Multicenter, Parallel Group Study to Compare Relative Efficacies of the Topical Gels 3% Erythromycin/5% Benzoyl Peroxide and 0.025% Tretinoin/Erythromycin 4% in the Treatment of Moderate Acne Vulgaris of the Face.
    Bernstein, et al. 1980. Topically applied erythromycin in inflammatory acne vulgaris.
    Bojar, et al. 2006. The short-term treatment of acne vulgaris with benzoyl peroxide: effects on the surface and follicular cutaneous microflora.

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