I. What is Erythromycin?

Erythromycin is a macrolide antibiotic or broad spectrum antibiotic. It is used to treat respiratory tract infection and other types of bacterial infection. Erythromycin is a product of the soil bacteria known as Streptocyces erythreus. It inhibits the protein synthesis and replication functions of bacteria.

II. How does Topical Erythromycin works on acne?

Erythromycin is a compound that kills and inhibits the growth of bacteria. This includes the bacteria that cause inflammation of the oil gland in acne prone skin. The topical erythromycin acts directly on the skin pores instead of being delivered from inside the body. Topical erythromycin does not have the side effects and dangers of oral antibiotics such as upset stomach and in severe cases kidney failure.

Advantages

Directly kills acne causing bacteria without the side effects of oral antibiotics which include upset stomach, diarrhea and dizziness. Topical antibiotics are safer to use than oral or systemic antibiotics. If your acne is not very severe you should always use topical antibiotics as oral antibiotics have nasty side-effects when used for long periods of time.

Disadvantages

Antibiotic treatment is prone to what is known as bacterial resistance. Bacterial resistance is a condition where the acne causing bacteria is already immune to the germ killing power of the specific antibiotic used. The only solution to bacterial resistance is the use of another antibiotic or the use of products which does not induce bacterial resistance like benzoyl peroxide or azelaic acid.

Efficacy

Topical erythromycin is just as effective as oral erythromycin but with fewer side effects. It is also safer to use topical erythromycin for long term use compared to the oral or systemic version.

4% topical erythromycin with 1.2% zinc acetate liquid and gel were statistically significantly better than a placebo and as effective as the 250mg oral tetracycline given twice daily.
( Source: Feucht CL, Allen BS, Chalker DK, Smith JG Jr. J Am Acad Dermatol. 1980 Nov;3(5):483-91)

Topical erythromycin 1.5 percent and clindamycin 1.0 percent appeared to be clinically equivalent for treating moderate facial acne.
( Source: Thomas DR, Raimer S, Smith EB., Cutis. 1982 Jun;29(6):624-5, 628-32)

A 2% solution of erythromycin applied to moderately severe facial acne was found to be superior to the blank vehicle in reducing the number of inflamed papules. During a period of 12 weeks, such papules were reduced by 56% in the erythromycin group, compared with 33% in the blank vehicle group. In the erythromycin group, 62% of the subjects had a good or excellent response, compared with 27% of those in the blank vehicle group.
( Source: Jones EL, Crumley AF., Arch Dermatol. 1981 Sep;117(9):551-3)

III. Forms, Dosage and Administration

lotion, gel or pledget. This type of medication is designed for topical application only. Wash first the affected area and pat dry with towel. Apply a thin layer of topical erythromycin on the affected area. Do not use more than what is necessary and avoid contact with the eyes and mucus membranes. The usual application frequency is twice daily.

IV. Precautions

Do not use topical corticosteroids at the same time with this product. Check if you have allergic reaction with this medication. Symptoms of allergic reaction include rashes, itching sensation and swelling.

V. Side Effects

This product may cause redness, dry skin, eye irritation and oily skin.

Brand Names

Stiemycin® solution, Eryacne® gel,A/T/S, Erycette, T-Stat

References

http://www.medicinenet.com/erythromycin-topical_ointment/article.htm "Topical Erythromycin Ointment" ( last update 2005)

Page last modified: January 07, 2008