Erythromycin Ophthalmic: A Concise Review

Erythromycin ophthalmic is an eye ointment used to treat and prevent bacterial eye infections. It is an antibiotic belonging to the macrolide class, which inhibits bacterial growth. Erythromycin is effective against both Gram-positive and Gram-negative bacteria. Notably, it has a greater impact on Gram-positive bacteria due to its ability to penetrate their cell walls more easily.

Key uses of erythromycin ophthalmic include:

• Treating conjunctivitis, an infection of the outer eye membrane
• Preventing gonococcal ophthalmia neonatorum in newborns exposed to Neisseria gonorrhoeae during birth
• Treating trachoma, an eye infection caused by Chlamydia trachomatis

The organisms susceptible to erythromycin ophthalmic include:

• Streptococcus pyogenes
• Staphylococcus aureus, including penicillinase-producing strains
• Streptococcus pneumoniae
• Streptococcus viridans
• Corynebacterium diphtheriae
• Chlamydia trachomatis
• Neisseria gonorrhoeae
• Mycoplasma pneumoniae
• Haemophilus influenzae
• Treponema pallidum

Warnings

• Do not use erythromycin ophthalmic if you have a history of hypersensitivity to erythromycin or any components of the formulation.
• Do not use erythromycin ophthalmic to treat infections resistant to erythromycin.
• Prolonged use of erythromycin ophthalmic, especially in combination with other antibacterial agents, can cause overgrowth of non-susceptible organisms, leading to fungal or bacterial superinfections. If signs of superinfection occur, discontinue use and seek appropriate treatment.
• In the absence of a proven or strongly suspected bacterial infection, or a prophylactic indication, the use of erythromycin ophthalmic is unlikely to be beneficial and increases the risk of developing drug-resistant bacteria.

Side Effects

Common side effects of erythromycin ophthalmic include minor eye irritation, redness, itching, stinging, burning, and hypersensitivity reactions such as skin rashes and hives. Seek immediate medical attention if you experience serious symptoms such as heart abnormalities, severe headache, nervous system reactions, or serious eye symptoms.

Dosages

Ophthalmic ointment:

Adult:

• Apply ½ inch (1.25 cm) once every 4-12 hours, depending on the severity of the infection

Trachoma (off-label):

• Apply once every 12 hours for 2 months or once every 12 hours on day 5 of each month for 6 months as an alternative

Pediatric:

Conjunctivitis:

• Apply ½ inch (1.25 cm) once every 4-12 hours, depending on the severity of the infection

Gonococcal Ophthalmia Neonatorum:

• Apply from unit dose (1 cm) to the eyes of newborns immediately after birth for prophylaxis

Overdose:

Oral ingestion of erythromycin can cause symptoms such as nausea, vomiting, diarrhea, and abdominal cramps. Overdose treatment involves eliminating the undigested drug from the gastrointestinal tract, along with symptomatic and supportive care.

Drug Interactions

Inform your doctor of all medications you are currently taking, and consult with them before making any changes to prevent potential drug interactions. Erythromycin ophthalmic has no significant interactions with other drugs.

Pregnancy and Breastfeeding

• Animal studies have not shown evidence of fetal harm when using erythromycin ophthalmic during pregnancy. However, limited data are available for pregnant women. Use cautiously only when clearly needed.
• The extent of erythromycin systemic absorption through ophthalmic use is unknown. Exercise caution when using it while breastfeeding.

Additional Considerations

• Follow the instructions for using erythromycin ophthalmic precisely.
• Use only the provided applicator for applying erythromycin ophthalmic ointment.
• Avoid touching the applicator tip or other surfaces to prevent contamination.
• Remember that erythromycin is only effective against bacterial, not viral infections.
• Complete the prescribed treatment and do not miss doses. Discontinuing therapy prematurely or missing doses can reduce effectiveness and contribute to the development of drug-resistant bacteria.
• If you experience persistent itching, stinging, or burning in the eye after using erythromycin ophthalmic, discontinue use and seek medical attention.
• Store erythromycin out of reach of children.
• In case of overdose, seek medical attention or contact Poison Control.

Summary

Erythromycin ophthalmic is an eye ointment used to treat and prevent bacterial eye infections. It is a broad-spectrum antibiotic that inhibits bacterial growth. Common side effects include minor eye irritation, redness, itching, stinging, burning, skin rashes, and hives. Consult your doctor if you are pregnant or breastfeeding.