erythromycin
Regulatory sources consulted
Approved indications
- Topical treatment of acne vulgaris.
Contraindications
Absolute
- Hypersensitivity to any component.
Clinical warnings
- Major warning · Consider pseudomembranous colitis in diarrhea after antibiotic exposure; it may be severe or life-threatening. — FDA/openFDA, SPL set_id 00c4f27e-59e2-4173-99b1-59dd295e83de
- For external use only; avoid the eyes, nose, mouth, and mucous membranes. Discontinue if resistant organisms overgrow. — FDA/openFDA, SPL set_id 00c4f27e-59e2-4173-99b1-59dd295e83de
- Major warning · Peeling, dryness, itching, erythema, and oily skin have occasionally been reported; generalized urticaria requiring systemic corticosteroids has also been reported, with no estimable frequency. — FDA/openFDA, SPL set_id 00c4f27e-59e2-4173-99b1-59dd295e83de
Drug interactions
- ModerateOther peeling, desquamating, or abrasive topical acne treatments
Mechanism: Cumulative local irritation may increase.
Recommendation: Use together only under supervision and reduce frequency if irritation occurs.
FDA/openFDA, SPL set_id 00c4f27e-59e2-4173-99b1-59dd295e83dehttps://api.fda.gov/drug/label.json?search=openfda.spl_set_id:00c4f27e-59e2-4173-99b1-59dd295e83de
Pregnancy and lactation
During pregnancy, use only if clearly needed. During breastfeeding, use cautiously because excretion after topical use is unknown.
Recent literature (PubMed)
Acne vulgaris commonly affects adults, adolescents, and preadolescents aged 9 years or older. The objective of this study was to provide evidence-based recommendations for the management of acne. A work group conducted a systematic review and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of evidence and formulating and grading recommendations. This guideline presents 18 evidence-based recommendations and 5 good practice statements. Strong recommendations are made for benzoyl peroxide, topical retinoids, topical antibiotics, and oral doxycycline. Oral isotretinoin is strongly recommended for acne that is severe, causing psychosocial burden or scarring, or failing standard oral or topical therapy. Conditional recommendations are made for topical clascoterone, salicylic acid, and azelaic acid, as well as for oral minocycline, sarecycline, combined oral contraceptive pills, and spironolactone. Combining topical therapies with multiple mechanisms of action, limiting systemic antibiotic use, combining systemic antibiotics with topical therapies, and adding intralesional corticosteroid injections for larger acne lesions are recommended as good practice statements. Analysis is based on the best available evidence at the time of the systematic review. These guidelines provide evidence-based recommendations for the management of acne vulgaris.
Acne is one of the most common dermatological conditions to affect women of childbearing age, so it is important to consider the safety of long-term acne treatments on women who could become pregnant. In this review article, we clarify what management options are available to treat acne during pregnancy. Topical treatments, typically first-line for acne, such as azelaic acid, clindamycin, erythromycin, metronidazole, benzoyl peroxide, salicylic acid, dapsone, and retinoids, were reviewed. Systemic treatments, such as zinc supplements, cephalexin, cefadroxil, amoxicillin, azithromycin, erythromycin, and corticosteroids, typically second-line for acne, were also reviewed. Alternative treatments such as light therapy and cosmetic procedures were also evaluated. Due to recommendation of sunscreen utilization during acne treatments, sunscreen usage during pregnancy was also assessed. Management of acne during unplanned pregnancy was discussed in further detail regarding safety and adverse effects. Through summarized tables and examples of studies demonstrating safety and efficacy of treatments, the following is a resource for providers and patients to utilize for management of acne during pregnancy. This sheet is about exposure to erythromycin during pregnancy and while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider. Roxithromycin is not approved for marketing in the United States by the U.S. Food and Drug Administration, but is available in other countries. Because of the low levels of roxithromycin in breastmilk, it would not be expected to cause adverse effects in breastfed infants. Monitor the infant for possible effects on the gastrointestinal flora, such as diarrhea, candidiasis (thrush, diaper rash). Unconfirmed epidemiologic evidence indicates that the risk of infantile hypertrophic pyloric stenosis might be increased by maternal use of macrolide ant