Erythromycin (EENT) (monograph)

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Veröffentlicht am 19.10.2025

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introduction

Uses for Erythromycin (EENT)

Bacterial eye infections

Topical treatment of superficial infections of the eye involving the conjunctiva and/or cornea caused by sensitive bacteria.

Mild, acute bacterial conjunctivitis often resolves spontaneously without anti-infective treatment. Although topical ophthalmic anti-infectives can shorten the time to improvement and reduce the severity and risk of complications, avoid indiscriminate use of topical anti-infectives.

Treatment of acute bacterial conjunctivitis is generally empirical; Use of a broad-spectrum topical ophthalmic antibiotic is usually recommended. In vitro staining and/or cultures of conjunctival material are indicated in the diagnosis and treatment of all cases of suspected infectious conjunctivitis in newborns, all cases of suspected gonococcal or chlamydial conjunctivitis, and may be indicated in the treatment of recurrent, severe, or chronic purulent conjunctivitis when acute conjunctivitis does not respond to initial empirical topical treatment.

Bacterial conjunctivitis caused by Neisseria gonorrhoeae requires treatment with systemic anti-infectives (e.g., intramuscular or intravenous ceftriaxone) with or without topical anti-infectives. Topical anti-infectives alone are not sufficient to treat ophthalmia neonatorum caused by N. gonorrhoeae; Some experts state that additional use of topical anti-infectives is unnecessary when appropriate systemic anti-infectives are used.

Chlamydia eye infections

Used topically to treat conjunctivitis secondary to trachoma caused by Chlamydia trachomatis† [off-label]; However, systemic anti-infectives (usually oral azithromycin) are recommended for the treatment of ocular trachoma.

Systemic anti-infectives (e.g., oral azithromycin, doxycycline, or erythromycin) are required for the treatment of chlamydial conjunctivitis, including chlamydial ophthalmia neonatorum. Experts state that topical anti-infectives alone are not enough to treat chlamydial eye infections and are unnecessary when using appropriate systemic anti-infectives.

Used for topical prophylaxis of ophthalmia neonatorum caused by C. trachomatis. However, the effectiveness of topical prophylaxis in preventing chlamydial conjunctivitis in newborns has not been established. Experts state that erythromycin, used for topical prophylaxis of gonococcal ophthalmia neonatorum, cannot prevent chlamydial ophthalmia neonatorum.

Prophylaxis of gonococcal ophthalmia neonatorum

Topical prophylaxis of ophthalmia neonatorum caused by N. gonorrhoeae. Efficacy for prevention of ophthalmia neonatorum caused by penicillinase-producing N. gonorrhoeae not established.

CDC and AAP recommend topical erythromycin prophylaxis in all newborns as soon as possible after birth (regardless of whether they are delivered vaginally or by cesarean section); Such prophylaxis is required by law in most states. Although silver nitrate and tetracycline have been used in the past for topical prophylaxis of gonococcal ophthalmia neonatorum, ophthalmic preparations of these drugs are no longer commercially available in the United States.

If erythromycin ophthalmic ointment is not available, the CDC recommends systemic prophylaxis with a single dose of ceftriaxone (IM or IV) for all newborns at risk of exposure to N. gonorrhoeae (particularly those born to women at risk of gonococcal infection or who did not receive prenatal treatment). Care).

Infants born to women with untreated gonorrhea are at high risk of infection; CDC and AAP recommend that such neonates receive systemic prophylaxis with a single dose of ceftriaxone (IM or IV) instead of topical erythromycin prophylaxis.

Erythromycin (EENT) dosage and administration

Administration

Ophthalmological administration

Apply 0.5% eye ointment topically to the eye.

For topical ophthalmological use only.

Avoid contaminating the tip of the ointment tube with material from eyes, fingers, or other sources.

In the prophylaxis of gonococcal ophthalmia neonatorum, apply the specified amount of ointment to the lower conjunctival sacs of the newborn and massage gently to distribute the ointment. After 1 minute, wipe off excess ointment with sterile cotton wool. Do not rinse the ointment from the eye after application. Use a new tube or disposable container of ointment for each newborn.

dosage

Pediatric patients

Bacterial eye infections

Ophthalmology

Apply a 1 cm strip of 0.5% ointment to the affected eye(s) up to 6 times daily. For the empirical treatment of acute bacterial conjunctivitis, experts recommend use 4 times a day for 1 week.

Prophylaxis of gonococcal ophthalmia neonatorum

Ophthalmology

Place a 1 cm band of 0.5% ointment into the inferior conjunctival sac of both eyes.

Administer as soon as possible (within one hour) after birth. Delaying topical prophylaxis for up to 1 hour after delivery (e.g. to facilitate parent-infant bonding) is unlikely to affect efficacy. Efficacy of prophylaxis administered after a long delay has not been studied.

Adult

Bacterial eye infections

Ophthalmology

Apply a 1 cm strip of 0.5% ointment to the affected eye(s) up to 6 times daily. For the empirical treatment of acute bacterial conjunctivitis, experts recommend use 4 times a day for 1 week.

Erythromycin (EENT) Precautions

Contraindications

Hypersensitivity to erythromycin.

Warnings/Precautions

Sensitivity reactions

Hypersensitivity

Possible hypersensitivity reactions.

General precautions

Superinfection

Prolonged use may cause overgrowth of non-susceptible organisms, including fungi.

If superinfection occurs, discontinue treatment and initiate appropriate therapy.

Specific populations

pregnancy

There are no data available for use in pregnant women. Use only when clearly necessary.

lactation

Use with caution in breastfeeding women.

Pediatric use

See uses.

Geriatric use

No overall differences in safety or effectiveness compared to younger patients.

Common side effects

Mild eye irritation, redness, hypersensitivity.

Pharmacokinetics of erythromycin (EENT).

absorption

extent

Topical application to the eye is unlikely to result in significant antibacterial concentrations in the deep layers of the cornea or in the aqueous humor.

It is not known whether erythromycin is significantly absorbed through mucous membranes.

stability

storage

Ophthalmology

ointment

15-25°C.

Do not expose to excessive heat; do not freeze.

Actions and spectrum

Normally bacteriostatic; can have a bactericidal effect in high concentrations or against very susceptible organisms.
Inhibits protein synthesis in susceptible organisms by binding to 50S ribosomal subunits.
Gram-positive bacteria: Active in vitro and in clinical infections against Staphylococcus aureus (methicillin-susceptible strains only), Streptococcus pneumoniae, S. pyogenes (group A β-hemolytic streptococci; GAS), viridans streptococci (α-hemolytic streptococci) and Corynebacterium diphtheriae.
Gram-negative bacteria: Active in vitro and in clinical infections against some strains of Haemophilus influenzae and Neisseria gonorrhoeae.
Active against Chlamydia trachomatis and Mycoplasma pneumoniae. Also has an effect against Treponema pallidum.

Advice for patients

Advise patients not to contaminate the tip of the ointment tube with material from the eye, fingers, or other sources.
Advise patients to discontinue erythromycin ophthalmic ointment immediately and to contact a physician at the first sign of a hypersensitivity reaction.
It is important to inform physicians about any existing or planned concomitant therapies, including prescription and over-the-counter medications, as well as any comorbidities.
It is important for women to tell doctors if they are pregnant, plan to become pregnant, or want to breastfeed.
It is important to inform patients of other important precautionary information. (See Precautions.)

Preparations

Excipients in commercial drug preparations may have clinically significant effects in some individuals; Details can be found on the respective product labeling.

For information about shortages of one or more of these drugs, visit the ASHP Drug Shortages Resource Center.

* Available from one or more manufacturers, distributors and/or repackagers under generic (non-proprietary) names

Erythromycin

Routes	Dosage forms	Strengthen	Brand names	Manufacturer
Ophthalmology	ointment	0.5%*	Erythromycin eye ointment

† Off-Label: Use is not currently included in U.S. Food and Drug Administration-approved labeling.

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