What is the use of Erythromycin (Erythromycin) ophthalmic (ophth) ointment?

From the Guidelines

Erythromycin ophthalmic ointment is recommended for the prevention of neonatal conjunctivitis and treatment of bacterial eye infections, with a single application of 0.5% ointment for newborns and up to 6 times daily for 7-10 days for adults and children, as directed by a healthcare provider. The medication works by inhibiting bacterial protein synthesis, preventing bacteria from growing and multiplying 1.

Key Points

• Erythromycin ophthalmic ointment is effective against many common eye pathogens including Staphylococcus, Streptococcus, and Chlamydia trachomatis.
• Common side effects include temporary blurred vision, eye irritation, and redness.
• The ointment should be applied with clean hands, and the tip of the tube should not touch any surface to prevent contamination.
• If symptoms worsen or do not improve after 2 days, medical attention should be sought.

Treatment Guidelines

• For newborns, a single application of 0.5% erythromycin ointment should be placed in each eye within 24 hours after birth, as recommended by the 2006 guidelines for sexually transmitted diseases treatment 1.
• For bacterial conjunctivitis in adults and children, apply a small amount (approximately 1 cm) to the affected eye(s) up to 6 times daily for 7-10 days, or as directed by a healthcare provider.

Additional Considerations

• Topical antibiotics, such as erythromycin, have been shown to provide some symptomatic relief and decrease bacteria from the eyelid margin in cases of anterior blepharitis, as noted in the 2024 blepharitis preferred practice pattern 1.
• Oral tetracyclines and topical antibiotics may be helpful for patients with meibomian gland dysfunction (MGD) whose chronic symptoms and signs are not adequately controlled by eyelid cleansing or meibomian gland expression 1.

From the FDA Drug Label

For the treatment of superficial ocular infections involving the conjunctiva and/or cornea caused by organisms susceptible to erythromycin. For prophylaxis of ophthalmia neonatorum due to N. gonorrhoeae or C. trachomatis.

• Indications for erythromycin ophth ointment include treatment of superficial ocular infections and prophylaxis of ophthalmia neonatorum.
• The ointment is used to treat infections of the conjunctiva and/or cornea caused by susceptible organisms.
• It is also used for prophylaxis against N. gonorrhoeae or C. trachomatis in newborns 2.
• The dosage for treatment of superficial ocular infections is approximately 1 cm in length applied directly to the infected eye(s) up to six times daily, depending on the severity of the infection 2.

From the Research

Erythromycin Ophthalmic Ointment

• Erythromycin ophthalmic ointment is used to treat certain eye infections, including blepharokeratitis and bacterial conjunctivitis 3, 4.
• The standard therapy for adult blepharokeratitis includes lid hygiene, topical corticosteroid preparations, and topical antibiotics, but oral erythromycin may be a reasonable alternative in childhood blepharokeratitis 3.
• Erythromycin has been shown to be effective in treating blepharokeratitis in children, with a study reporting successful treatment in 5 children 3.
• Topical antibiotics, such as erythromycin, are commonly used to treat bacterial conjunctivitis, with the choice of antibiotic depending on the suspected or confirmed causative organism 5, 6, 4.
• The most prevalent species causing bacterial conjunctivitis include Haemophilus influenzae, Staphylococcus epidermidis, and Streptococcus pneumoniae, with varying levels of antibiotic resistance 6.

Mechanism of Action and Resistance

• Erythromycin is a macrolide antibiotic that works by inhibiting protein synthesis in bacteria 3.
• Resistance to erythromycin and other macrolide antibiotics has been reported, particularly among certain species such as Streptococcus pneumoniae and Staphylococcus aureus 6.

Clinical Use

• Erythromycin ophthalmic ointment is typically applied topically to the affected eye, with the frequency and duration of treatment depending on the severity of the infection and the clinical response 3, 4.
• It is essential to follow the recommended treatment regimen and to complete the full course of treatment to ensure effective resolution of the infection and to minimize the development of antibiotic resistance 5, 6, 4.