Erythromycin antimicrobial therapy

Systemic or topical antimicrobial therapy (tetracycline, minocycline, erythromycin, at low dose) is used over months (response begins after 2 months). Bacterial resistance is not a problem benefit is due to suppression of bacterial lipolysis of sebum, which generates inflammatory fatty acids. Raised intracranial pressure with loss of vision has occurred with tetracycline used thus. 

Erythromycin estolate in conjunction with rifampin (both drugs administered orally) can be recommended for the treatment of Rhodococcus equi pneumonia in foals. Early diagnosis of the infection and prompt initiation of therapy considerably increase the effectiveness of treatment. Apart from this specific indication, macrolide antibiotics (including erythromycin) and lincosamides (lincomycin and clindamycin) are contra-indicated in horses. Antimicrobial agents in these classes can cause severe disturbance of the balance between commensal bacterial flora in the colon of the horse. 

Resistant strains of P. acnes are emerging that may respond to jndicions nse of retinoids in combination with antibiotics. Commonly nsed topical antimicrobials in acne inclnde erythromycin, clindamycin (Cleocin-t), and benzoyl peroxide and antibiotic-benzoyl peroxide combinations (Benzamycin, Benzaclin, others). Other antimiaobials nsed in treating acne inclnde sulfacetamide (Klaron), sulfacetamide/sulfur combinations (Snlfacet-R), metronidawie (Metrocream, Metro-Gel, noritate), and azelaic acid (Azelex). Systemic therapy is prescribed for patients with more extensive disease and acne that is resistant to topical therapy. Effective agents inclnde tetracycline (snmycin, others), minocycline (MINO-CIN, others), erythromycin (ERYC, others), clindamycin (CLEOCIN), and trimethoprim-sulfamethoxazole (bactrim, others). Antibiotics nsnally are administered twice daily, and doses are tapered after control is achieved. 

Used as a prophylactic agent for rheumatic fever, 150 mg roxithromycin taken once daily was found to be a suitable alternative to penicillin and erythromycin [179]. In neutropenic patients with acute leukemia and in bone marrow transplant recipients receiving ofloxacin prophylaxis, the addition of roxithromycin resulted in less bacteremia due to viridans group streptococci (0% vs. 9% in ofloxacin alone). However, incidences of bacteremia caused by other organisms, febrile episodes from any cause, infection-associated complications, and antimicrobial usage for therapy were similar between the two groups [180]. 

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