Erythromycin and Co-Trimoxazole (Bactrim or Septrim)

Erythromycin

Erythromycin is the second most commonly prescribed antibiotic in acne. It works just as well as tetracycline and is safer, so it is surprising that it is not more commonly used. The reason may be that physicians are used to prescribing tetracycline, and cost - erythromycin is more expensive. Erythromycin is therefore usually used as a second-line or reserve antibiotic for patients who cannot take tetracycline for some of the reasons mentioned above, and for those whose acne does not improve with tetracycline. Erythromycin reduces the number of P. acnes and also reduces the migration of white blood cells to the area of inflammation.

Side effects do occur with erythromycin but are generally less severe than with tetracyclines. Erythromycin however, is more prone to cause gastric and intestinal side effects.


Co-Trimoxazole (Bactrim or Septrim)

Co-trimoxazole is another antibiotic active against P. acnes. It is used in severe nodular and cystic acne and other types of acne that do not respond to the antibiotics mentioned above. Co-trimoxazole also appears to be effective against Gram-negative folliculitis.

Co-trimoxazole cannot be used in pregnant women and persons allergic to sulphur drugs, sulphonomides. It many cause severe drug rashes and may also adversely affect blood cells. Regular blood checks are necessary in those taking this drug for a long time.



NO MORE PIMPLES, A SELF-CARE GUIDE, DR. LIM KAH-BENG