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.
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).
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.
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 (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
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)
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.