A / t / s
Name: A / T / S
- A / T / S drug
- A / T / S side effects
- A / T / S tablet
- A / T / S effects of
- A / T / S used to treat
- A / T / S adult dose
- A / T / S 500 mg
- A / T / S adverse effects
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking A/T/S (erythromycin topical)?
Avoid using other medications on the areas you treat with erythromycin topical unless your doctor tells you to.
Avoid using skin products that can cause irritation, such as harsh soaps or skin cleansers, or skin products with alcohol, spices, astringents, or lime.
Avoid getting this medication in your eyes, mouth, and nose, or on your lips. If it does get into any of these areas, rinse with water.
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking erythromycin topical and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.
What other drugs will affect A/T/S (erythromycin topical)?
It is not likely that other drugs you take orally or inject will have an effect on topically applied erythromycin. But many drugs can interact with each other. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
Erythromycin is a prescription medication used to treat infections caused by bacteria.
Erythromycin belongs to a group of drugs called macrolide antibiotics. These work by killing or stopping the growth of the bacteria that cause infections.
This medication comes in capsule, tablet, long-acting capsule, long-acting tablet, chewable tablet, suspension, and pediatric drop forms for oral use. It is usually taken 3 to 4 times daily.
This medication also comes in topical solution and gel forms and as an ophthalmic ointment.
Do not chew, divide, or break the long-acting capsules and tablets. Swallow these whole and take with a full glass of water.
This medication is also available in an injectable form to be given directly into a vein (IV) by a healthcare professional.
Common side effects of erythromycin include stomach upset, diarrhea, vomiting, stomach cramps, mild skin rash, and stomach pain.
Ophthalmic erythromycin can also cause blurred vision. Do not drive or operate heavy machinery until you know how erythromycin affects you.
If you take too much erythromycin, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.
If erythromycin is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.
Usual Adult Dose for Acne
Gel: Spread gently over affected areas (without rubbing in) once or twice a day.
Ointment, solution, swabs: Apply to affected areas once or twice a day.
Areas to be treated should be cleansed prior to application. The duration of therapy depends on the response of the patient. Maximum response may not occur for up to 12 weeks.
Renal Dose Adjustments
Data not available
Erythromycin Levels and Effects while Breastfeeding
Summary of Use during Lactation
Because of the low levels of erythromycin in breastmilk and safe administration directly to infants, it is acceptable in nursing mothers. The small amounts in milk are unlikely to cause adverse effects in the infant. Monitor the infant for irritability and possible effects on the gastrointestinal flora, such as diarrhea, candidiasis (thrush, diaper rash). One case report and unconfirmed epidemiologic evidence indicates that the risk of hypertrophic pyloric stenosis in infants might be increased by maternal use of erythromycin during breastfeeding.
Infant side effects are unlikely with topical application for acne, although topical application to the nipple may increase the risk of diarrhea in the infant. Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.
Maternal Levels. Two women were given a single dose of 500 mg erythromycin (salt unspecified) orally, and milk levels were measured at 2 and 6 hours after the dose. Average erythromycin milk levels at 2, 4, and 6 hours after the dose were 1, 1.2 and 1.1 mg/L, respectively.
Fifteen women who were 1 month postpartum were given a single 500 mg dose of erythromycin intravenously. Mean breastmilk levels 2 hours after the dose were 2.5 mg/L.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
Pyloric stenosis, vomiting, sedation, poor sucking and poor weight gain probably related to erythromycin in breastmilk was reported in a 3-week-old infant.
A cohort study of infants diagnosed with infantile hypertrophic pyloric stenosis found that affected infants were 2.3 to 3 times more likely to have a mother taking a macrolide antibiotic during the 90 days after delivery. Stratification of the infants found the odds ratio to be 10 for female infants and 2 for male infants. All of the mothers of affected infants nursed their infants. Seventy-two percent of the macrolide prescriptions were for erythromycin. However, the authors did not state which macrolide was taken by the mothers of the affected infants.
A study comparing the breastfed infants of mothers taking amoxicillin to those taking a macrolide antibiotic found no instances of pyloric stenosis. However, most of the infants exposed to a macrolide in breastmilk were exposed to roxithromycin. Only 2 of the 55 infants exposed to a macrolide were exposed to erythromycin. Adverse reactions occurred in 12.7% of the infants exposed to macrolides which was similar to the rate in amoxicillin-exposed infants. Reactions included rash, diarrhea, loss of appetite, and somnolence.
A retrospective database study in Denmark of 15 years of data found a 3.5-fold increased risk of infantile hypertrophic pyloric stenosis in the infants of mothers who took a macrolide during the first 13 days postpartum, but not with later exposure. The proportion of infants who were breastfed was not known, but probably high. The proportion of women who took each macrolide was also not reported.
In one telephone follow-up study, mothers reported diarrhea 2 infants and irritability in 2 infants out of 17 infants whose mothers were taking erythromycin during breastfeeding. None of the reactions required medical attention.
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
Alternate Drugs to Consider
(Systemic Infections) Azithromycin, Clarithromycin, (Topical for Acne) Azelaic Acid, Benzoyl Peroxide, Clindamycin, Tretinoin
1. Noti A, Grob K, Biedermann M. Exposure of babies to C(15)-C(45) mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 2003;38:317-25. PMID: 14623482
2. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol. 1984;5:57-60. PMID: 6743732
3. Zhang Y, Zhang Q, Xu Z. [Tissue and body fluid distribution of antibacterial agents in pregnant and lactating women]. Zhonghua Fu Chan Ke Za Zhi. 1997;32:288-92. PMID: 9596854
4. Stang H. Pyloric stenosis associated with erythromycin ingested through breast milk. Minn Med. 1986;69:669-70, 82. PMID: 3796569
5. Sorensen HT, Skriver MV, Pedersen L et al. Risk of infantile hypertrophic pyloric stenosis after maternal postnatal use of macrolides. Scand J Infect Dis. 2003;35:104-6. PMID: 12693559
6. Ito S, Blajchman A, Stephenson M et al. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993;168:1393-9. PMID: 8498418
7. Goldstein LH, Berlin M, Tsur L et al. The safety of macrolides during lactation. Breastfeed Med. 2009;4:197-200. PMID: 19366316
8. Lund M, Pasternak B, Davidsen RB et al. Use of macrolides in mother and child and risk of infantile hypertrophic pyloric stenosis: Nationwide cohort study. BMJ. 2014;348:g1908. PMID: 24618148
LactMed Record Number
Last Revision Date
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