AfyaIndex — Drug Search

01 Risk first

Safety essentials

The information most likely to change a prescribing or dispensing decision.

Contraindications

Hypersensitivity to macrolides.
Clarithromycin/erythromycin: concomitant strong CYP3A4 substrates with narrow therapeutic index where interaction is labelled contraindicated (e.g. certain ergot alkaloids, some statins — check SmPC).
History of cholestatic jaundice/hepatic dysfunction with prior macrolide.

Precautions

WARNINGS Pseudomembranous colitis has been reported with nearly all antibacterial agents, including erythromycin, and may range in severity from mild to life-threatening.
Therefore, it is important to consider this diagnosis in patients who present with diarrhea subsequent to the administration of antibacterial agents.
Treatment with antibacterial agents alters the normal flora of the colon and may permit overgrowth of clostridia.
Studies indicate that a toxin produced by Clostridium difficile is one primary cause of “antibiotic-associated colitis”.
After the diagnosis of pseudomembranous colitis has been established, therapeutic measures should be initiated.
Mild cases of pseudomembranous colitis usually respond to drug discontinuation alone.
In moderate to severe cases, consideration should be given to management with fluids and electrolytes, protein supplementation and treatment with an antibacterial drug clinically effective against C. difficile colitis.

02 Point of care

Dosing matrix

Population and organ-function guidance, shown together for faster comparison.

Adult

DOSAGE AND ADMINISTRATION Erythromycin Topical Solution USP, 2% should be applied over the affected areas twice a day (morning and evening) after the skin is thoroughly washed with warm water and soap and patted dry. Acne lesions on the face, neck, shoulders, chest, and back may be treated in this manner. This medication should be applied with applicator top. If fingertips are used, wash hands after application. Drying and peeling may be controlled by reducing the frequency of applications.

Paediatric

Pediatric Use - Safety and effectiveness of this product in pediatric patients have not been established.

Renal

Usually less critical than beta-lactams; still review SmPC for severe impairment.

CrCl 0–120: Confirm renal dosing in product SmPC / primary label.

Hepatic

Hepatotoxicity recognised (especially erythromycin estolate historically); monitor if prolonged therapy or prior liver disease.

03 Clinical use

Use, effects & interactions

Indications

INDICATIONS AND USAGE Erythromycin Topical Solution USP, 2% is indicated for the topical treatment of acne vulgaris.
Clinical selection for Erythromycin+ Zinc acenate Lotion should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
Class context: Macrolide [EPC], Macrolide Antimicrobial [EPC].
Confirm site-specific dose, duration and monitoring before prescribing.

Adverse effects

ADVERSE REACTIONS The following local adverse reactions have been reported occasionally: peeling, dryness, itching, erythema, and oiliness.
Irritation of the eyes and tenderness of the skin have also been reported with topical use of erythromycin.
Generalized urticarial reactions possibly related to the use of erythromycin, which required systemic steroid therapy have been reported.

Drug interactions

Open multi-drug checker ↗

First-line for many atypical pneumonias and selected STIs.
Review drug–drug interactions before clarithromycin.
Resistance rising in streptococci/pneumococci in many regions — know local data.

04 Pharmacology

Mechanism & disposition

Combination product.

Bind ribosomeInhibit protein synthesisBacteriostatic / cidal

Read complete mechanism

Combination product. Component mechanism (Erythromycin): Binds to 50s sub-unit of the bacterial ribosome and inhibits bacterial protein synthesis by preventing attachment of aminoacyl transfer RNA to its acceptor site on the ribosome. This prevents peptide bond formation by peptidyl transferase.

Onset

2–3 hours

Duration

12–24 h+ (azithromycin long tissue half-life)

Route

ORAL / IV (agent-dependent)

05 Special populations

Pregnancy, lactation & diet

Pregnancy

Pregnancy: Teratogenic Effects: Pregnancy Category B - There was no evidence of teratogenicity or any other adverse effect on reproduction in female rats fed erythromycin base (up to 0.25% of diet) prior to and during mating, during gestation and through weaning of two successive litters. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used in pregnancy only if clearly needed. Erythromycin has been reported to cross the placental barrier in humans, but fetal plasma levels are generally low.

Lactation

Nursing Mothers - It is not known whether erythromycin is excreted in human milk after topical application. However, erythromycin is excreted in human milk following oral and parenteral erythromycin administration. Therefore, caution should be exercised when erythromycin is administered to a nursing woman.

06 Kenya market

Brands & loaded prices

From—

Median—

Listings0

Brand	Manufacturer	Pack	Observed price
No reviewed brand listings are linked yet.

07 Provenance

Sources & review state

Primary sourceLocal active-ingredient clinical extract; FDA drug label via OpenFDA/DailyMed; Component monographs (multi-source pipeline); Professional class pharmacology (Macrolide antibiotic)

Last reviewedNot recorded

EvidenceSource-linked

Open source document ↗

Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.