WHO Model Prescribing Information: Drugs Used in Skin Diseases
(1997; 132 pages) [French] [Spanish] View the PDF document
Table of Contents
View the documentPreface
View the documentIntroduction
Open this folder and view contentsParasitic infections
Open this folder and view contentsInsect and arachnid bites and stings
Open this folder and view contentsSuperficial fungal infections
Open this folder and view contentsSubcutaneous fungal infections
Open this folder and view contentsBacterial infections
Open this folder and view contentsViral infections
Open this folder and view contentsEczematous diseases
Open this folder and view contentsScaling diseases
Open this folder and view contentsPapulosquamous diseases
View the documentCutaneous reactions to drugs
Open this folder and view contentsPigmentary disorders
Open this folder and view contentsPremalignant lesions and malignant tumours
Open this folder and view contentsPhotodermatoses
Open this folder and view contentsBullous dermatoses
View the documentAlopecia areata
View the documentUrticaria
Open this folder and view contentsConditions common in children
View the documentAcne vulgaris
View the documentPruritus
View the documentTropical ulcers
Close this folderAntimicrobial drugs
View the documentAciclovir
View the documentBenzylpenicillin
View the documentClioquinol
View the documentErythromycin
View the documentMethylrosanilinium chloride (gentian violet)
View the documentNeomycin + bacitracin
View the documentTetracycline
View the documentTiabendazole
Open this folder and view contentsAntifugal drugs
Open this folder and view contentsAntiseptic agents
Open this folder and view contentsKeratoplastic and keratolytic agents
Open this folder and view contentsScabicides and pediculicides
Open this folder and view contentsAnti-inflammatory and antipruritic drugs1
Open this folder and view contentsAntiallergics and drugs used in anaphylaxis
Open this folder and view contentsUltraviolet radiation-blocking agents (sunscreens)
Open this folder and view contentsMiscellaneous drugs
Open this folder and view contentsAnnex
View the documentSelected WHO Publications of Related Interest
View the documentBack cover
 

Erythromycin

Cream or solution, 2%
Capsule or tablet, 250 mg (as stearate or ethyl succinate)

General information

Erythromycin is a macrolide antibiotic produced by Streptomyces erythreus. It has selective bacteriostatic activity against both streptococci and staphylococci, Propionibacterium acnes and some Gram-positive bacilli.

Because erythromycin is inactivated by gastric juices, oral formulations are protected by enteric coating. The drug diffuses rapidly into all tissues except the brain and cerebrospinal fluid. It readily crosses the placental barrier, and low concentrations have been reported in fetal plasma. The plasma half-life is approximately 90 minutes. Erythromycin is partially demethylated in the liver and excreted largely via the bile and faeces.

Clinical information

Uses

Treatment of:

• mild to moderate inflammatory acne
• severe impetigo unresponsive to topical antibiotics
• folliculitis
• erysipelas and cellulitis
• moderate to severe acne in patients in whom tetracyclines are contraindicated or ineffective
• yaws in children under 8 years of age, in whom tetracyclines are contraindicated.

Dosage and administration

Erythromycin tablets should not be broken in half before administration.

Mild to moderate inflammatory acne:

A thin layer of cream or solution should be applied to affected areas twice daily for 8-12 weeks.

Severe impetigo, folliculitis, erysipelas, cellulitis and moderate to severe acne:

Adults: 250 mg four times daily for 7-10 days. Patients with acne should receive 250 mg four times daily for 6-8 weeks followed by 250 mg twice daily until improvement occurs. Treatment may need to be continued for up to 6 months.

Children: 30 mg/kg daily in four divided doses for 7-10 days.

Yaws in children under 8 years:

30 mg/kg in four divided doses for 7-10 days.

Contraindications

Known hypersensitivity to erythromycin.

Precautions

Hepatic function should be monitored in patients with a previous history of liver disease.

Use in pregnancy

Erythromycin has not been shown to be mutagenic, teratogenic or embryotoxic; it can be used during pregnancy.

Adverse effects

Nausea, vomiting and diarrhoea can occur.

Cholestatic hepatitis, which may present with symptoms suggestive of acute cholecystitis, occasionally complicates prolonged courses of treatment. Symptoms resolve rapidly when the drug is withdrawn.

Anaphylaxis and other hypersensitivity reactions are rare.

Drug interactions

Erythromycin, chloramphenicol and clindamycin have a similar bacteriostatic action and tend to be mutually antagonistic when administered together. Erythromycin decreases the rate of metabolism of carbamazepine and warfarin in the liver to a degree that can warrant readjustment of dosage. Erythromycin may diminish the action of oral contraceptives. Convulsions have recently been reported to occur when erythromycin is given together with a non-steroidal anti-inflammatory agent.

Erythromycin and other macrolide antibiotics should not be given with the non-sedating antihistamines astemizole and terfenadine, as cardiac arrhythmias such as prolonged Q-T intervals and ventricular arrhythmias (including ventricular fibrillation) have been reported in association with these drug combinations.

Overdosage

Symptoms of overdosage include severe nausea, vomiting, diarrhoea and hearing loss. Induction of emesis or gastric lavage may be of value if undertaken within a few hours of ingestion.

Storage

Preparations should be stored in tightly closed containers. Tablets and capsules should be protected from light.

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