Erythromycin Dosing for Erythrasma
For erythrasma, the recommended dose of erythromycin is 250 mg orally four times daily for 14 days. 1
Dosing Regimen
- Adults: Erythromycin 250 mg orally four times daily for 14 days is the treatment of choice for erythrasma 1
- This regimen demonstrates cure rates as high as 100% in clinical studies 1
Alternative Formulations
If using erythromycin ethylsuccinate instead of the base formulation:
- Erythromycin ethylsuccinate: 400 mg orally four times daily for 14 days 2
- This provides equivalent dosing when accounting for the different salt formulation 2
Clinical Efficacy Considerations
- Systemic erythromycin shows greater efficacy for axillary and groin involvement compared to tetracyclines 1
- For interdigital infections, erythromycin has similar efficacy to tetracyclines 1
- When systemic therapy fails or for extensive intertriginous involvement, topical agents (clindamycin, fusidic acid, or Whitfield's ointment) may be added 1
Important Caveats
- Complete the full 14-day course to prevent relapse, as shorter durations may lead to treatment failure 1
- Topical fusidic acid has shown superior efficacy in some comparative trials and may be considered as first-line therapy, particularly for localized disease 3
- Single-dose clarithromycin (1 g) has demonstrated comparable efficacy to the 14-day erythromycin regimen and may improve compliance 3
- Be aware of gastrointestinal side effects with erythromycin, which may affect patient adherence 1