Don’t treat erythromycin ointment as a “national miracle drug”

Whether it is mosquito bites, acne, allergies, or inflammation, many people are accustomed to applying a little erythromycin ointment. Due to its low price, easy to carry, and simple and convenient to use, in the eyes of ordinary people, erythromycin ointment has become a new generation of "national magic medicine".

In daily life, is it really okay to use erythromycin ointment casually like this? In this regard, Teng Hailong, director of the pharmacy department and chief pharmacist of Mudanjiang Cardiovascular Hospital in Heilongjiang Province, and Zhao Yanzhao, deputy chief pharmacist, put forward opinions and suggestions on the use of erythromycin ointment.

Misuse can lead to drug-resistant bacteria

Teng Hailong introduced that the main ingredient of erythromycin ointment is erythromycin, which has good antibacterial activity against most Gram-positive bacteria such as Staphylococcus. A small amount of erythromycin is mixed with yellow vaseline and paraffin to make an ointment with a content of 1%, which is commonly known as erythromycin ointment. The indications of erythromycin ointment are clearly defined in the drug instructions. It is mainly suitable for the treatment of suppurative skin diseases such as impetigo, as well as small-area burns, ulcer surface infections and acne vulgaris.

Teng Hailong reminded that erythromycin ointment must be used for the right disease. If it is used for diseases that are not within the scope of the drug's application, it will not only be useless, but it may also cultivate drug-resistant bacteria. The more frequently it is used, the faster the bacteria will evolve and the stronger the drug resistance will be.

Teng Hailong used pneumonia as an example to explain: "The main pathogen of pneumonia is Streptococcus pneumoniae, and erythromycin is one of the 'killer weapons' against Streptococcus. Erythromycin has multiple dosage forms such as topical, oral and intravenous. Abuse of any of these preparations will deprive the disease of an effective treatment option."

Unfortunately, in recent years, with the widespread use of erythromycin preparations, drug-resistant bacteria have continued to emerge. The "2021 National Bacterial Resistance Monitoring Report" shows that the national average resistance rate of Streptococcus pneumoniae to erythromycin is 96.4%. Zhao Yanzhao warned that the occurrence of drug-resistant bacteria is closely related to the long-term abuse of antibiotics. If strains of Streptococcus pneumoniae that are insensitive to erythromycin prevail, erythromycin will be completely ineffective for people infected with these strains.

Five situations where it is not suitable to use

How should erythromycin ointment be used scientifically?

Zhao Yanzhao suggests that erythromycin ointment should not be used in the following situations:

First, sensitive parts, such as eyes, oral and nasal mucosa, should be avoided from applying erythromycin ointment as much as possible. Second, people with allergic constitutions. Erythromycin allergy is relatively rare, but such people still exist. If itchy, dry and burning skin occurs after taking the medicine, the medicine should be stopped immediately and the local medicine should be cleaned. Third, people with large-area burns and trauma should avoid using erythromycin ointment; people with severe wounds such as bedsores and hemorrhoids are not recommended to use erythromycin ointment. Fourth, when being bitten by mosquitoes and insects and having non-infectious diseases such as allergies, the medicine can be applied in an appropriate amount only when a professional doctor determines that there is a bacterial infection. Fifth, erythromycin ointment is not recommended for nose bleeding, urinary tract infection, and skin diseases caused by fungal or viral infections such as tinea capitis, tinea pedis, and herpes.

Do not mix eye ointments and ointments

Teng Hailong once met a pair of grandparents. Because the grandson's eyes were red, the old man applied some erythromycin eye ointment to him. After the ointment ran out, the old man used it directly on his grandson because he had erythromycin ointment at home. As a result, the child's eyes became more and more uncomfortable.

Zhao Yanzhao pointed out that many people have the habit of mixing erythromycin ointment and erythromycin eye ointment. After all, both look like "erythromycin" and there is only one word difference. In fact, the two drugs have very different ways of use and efficacy. "Erythromycin eye ointment is mainly used for trachoma, conjunctivitis or external eye infection. It is applied to the inside of the eyelid when used. Therefore, the drug production process requires strict aseptic operation to avoid drug contamination; erythromycin ointment is applied to the surface of the skin and is not a sterile preparation. Mixing them, especially using ointment as eye ointment, the consequences can be imagined." Zhao Yanzhao said.

In addition, the concentration of erythromycin eye ointment is 0.5%, while the concentration of erythromycin ointment is 1%, which is much higher than the former. If erythromycin eye ointment is used as ointment, the local antibacterial and anti-infection effect of the skin may be reduced due to insufficient concentration.

Follow doctor's advice to ensure safe medication

Teng Hailong warned that as an antibacterial drug, before using erythromycin ointment, it is necessary to confirm with a doctor or pharmacist and receive the corresponding medication guidance. At the same time, we must also be alert to the possibility of adverse reactions such as drug allergies. For special groups such as breastfeeding and pregnant women, children, the elderly, and people with poor liver and kidney function, the medication should be used under the guidance of a doctor.

If erythromycin ointment is used correctly, the symptoms will basically improve within 3 days, and you can continue to use the medicine until the symptoms disappear completely. However, if the symptoms are not relieved for more than 3 days, and the skin is accompanied by redness, swelling and pus, you should stop taking the medicine and seek medical attention immediately. In addition, erythromycin ointment should not be used frequently for a long time to avoid the emergence of drug-resistant bacteria.

Zhao Yanzhao emphasized that "all medicines are poisonous to some extent", and caution should be exercised whether using oral or topical medications. It is recommended to consult a professional doctor or pharmacist before use.