Erythromycin
Erythromycin is a macrolide antibiotic. In toddler skin care its main role is Perioral Dermatitis: a topical gel, or an oral course (with azithromycin or Clarithromycin as alternatives) in young children who must not have Tetracyclines (DermNet 2018). In one series of 106 children, 29 of them under 3, oral erythromycin for 4 weeks after stopping the facial steroid cleared 86% by 4 weeks and all by 8 weeks (Weston & Morelli, cited in Cutis 2017). Hall & Reichenberg’s 2010 review lists topical erythromycin among the better-evidenced treatments, though it works more slowly than oral tetracycline.
Erythromycin [treats] Perioral Dermatitis Erythromycin [relates] Tetracyclines
Not NICE’s toddler choice for skin infection. For Impetigo and Infected Eczema, NICE NG153 and NICE NG190 use erythromycin only where a macrolide is needed in pregnancy. The children’s tables give it for ages 8–17 only. For a penicillin-allergic toddler, NICE names Clarithromycin instead. DermNet adds that macrolides “may be adequate” for minor staph infections in penicillin-allergic patients, but macrolide resistance is high among Staphylococcus aureus.
NICE NG153 [regulates] Erythromycin Clarithromycin [relates] Erythromycin Antimicrobial Resistance [worsens] Erythromycin
Giving it to a toddler. Medicines for Children says oral erythromycin is usually given four times a day before meals, at least 3 hours apart. The suspension (125, 250 or 500 mg in 5 mL) can be diluted in a little water or squash, and sugar-free versions exist. Diarrhoea, stomach ache and vomiting are the usual problems. Facial swelling, rash with breathing difficulty, or a fit needs emergency care. Parents should check before giving an antihistamine, because erythromycin can make its side effects worse. That matters for an itchy eczematous toddler on a sedating antihistamine at night.
Erythromycin [relates] Parent Experiences
Connections
- Perioral Dermatitis — topical or oral macrolide for young children, source: DermNet; Cutis 2017
- Clarithromycin — preferred macrolide outside pregnancy for impetigo/infected eczema, source: NICE NG153
- Tetracyclines — used instead of tetracyclines in young children, source: DermNet 2018
- NICE NG153 — pregnancy-only macrolide for impetigo, source: NICE 2020
- Staphylococcus aureus — macrolide resistance common, source: DermNet 2015
- Antimicrobial Resistance — limits use for staph, source: DermNet 2015