Erythromycin Eye Ointment: Uses, Dosage, and Side Effects

Erythromycin ophthalmic ointment is an eye ointment used to treat bacterial eye infections like bacterial conjunctivitis in newborns and adults. Erythromycin is in a class of medications called macrolide antibiotics, which kill bacteria. It cannot treat eye infections due to a virus or fungus.

There are multiple brand names for this medication, including Ilotycin Ophthalmic and Romycin Ophthalmic, but there are also generic versions of this ointment.

This article explains erythromycin eye ointment uses, dosage, and side effects.

Uses for Erythromycin Ophthalmic Ointment

Erythromycin ophthalmic ointment is used for bacterial eye infections in adults and common eye infections in newborn babies.

Bacterial Conjunctivitis

Ophthalmic erythromycin is commonly prescribed for bacterial conjunctivitis (bacterial pink eye), which can cause red and swollen eyes.

Using an eye ointment for bacterial conjunctivitis can help you heal faster and allow earlier return to school or work.

Bacterial Keratitis

Bacterial keratitis is an infection of the cornea (the clear dome covering the colored part of the eye) caused by bacteria. It can also be treated with erythromycin eye ointment.

Blepharitis

Blepharitis is an inflammation of the eyelids caused by bacteria on the skin or at the base of the eyelashes or by problems with oil glands in the eyelids. Your healthcare provider will prescribe erythromycin eye ointment if you have this condition.

Infectious Uveitis

Uveitis can be caused by bacteria, a virus, a fungus, or parasites. When bacteria are the cause, antibiotic preparations like erythromycin eye ointment may be used as part of the treatment. Uveitis refers to swelling and irritation of the middle layer of the eye called the uvea.

Neonatal Conjunctivitis

Erythromycin ointment is used as a harmless and cost-effective means of treating neonatal conjunctivitis, which is also called ophthalmia neonatorum. Ophthalmic erythromycin can help prevent vision loss caused by bacteria that can enter the baby’s eyes during childbirth.

Chlamydia and gonorrhea are sexually transmitted infections caused by bacteria that can be introduced into a newborn’s eyes during childbirth through the mother's birth canal and permanently damage the corneas.

Newborns usually receive erythromycin ophthalmic ointment (0.5%) in each eye one time soon after birth. Erythromycin is the only antibiotic ointment recommended for use in newborns.

Before Applying Erythromycin Eye Ointment

Your healthcare provider will determine whether a virus, bacterium, or allergen is causing the conjunctivitis based on your health history, symptoms, and an eye examination. They may collect a sample of eye discharge from the infected eye and send it to the laboratory to identify the cause.

Wearing contact lenses is not recommended while using erythromycin ophthalmic ointment. The ointment can cause the contact lens to move out of its proper position, or may coat the lens and cause your vision to be blurry. Wearing your lenses can also cause irritation or aggravate your eye problem. Ask your healthcare provider when you can resume wearing contact lenses.

Be sure to let your healthcare provider know all the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. Also tell them if you are using any eye drops or eye medications.

Precautions and Contraindications

You should tell your healthcare provider if you’re allergic to erythromycin or any medication in this drug class. You should also inform your practitioner of any other allergies you have since erythromycin ophthalmic ointment may have inactive ingredients like mineral oil and petrolatum that can still cause allergic reactions.

After applying the ointment to your eye, you may have blurred vision for a short time. Avoid driving, working with any dangerous tools or machinery, or doing anything that requires you to be able to see clearly.

If you are pregnant, plan to become pregnant, or are breastfeeding, ask your healthcare provider if it's safe to use erythromycin ointment. The risks of this ointment passing into breast milk are not known.

Dosage

The dose of this medication will be determined by your healthcare provider, and will be different depending on the severity of the infection. Use erythromycin ophthalmic ointment exactly as directed.

For Adults

Approximately 1 cm in length (less than half an inch) of erythromycin ophthalmic ointment should be applied directly to the infected eye up to six times a day, depending on the severity of the infection.

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, use only that dose. Do not use double or extra doses.

For Babies

In newborn baby’s eyes, the healthcare provider will apply 1 cm of ointment to the small pocket below the baby’s eye one time right after delivery. The ointment should not be washed out of the baby's eyes.

How to Apply and Store

Here are some helpful tips on how to use erythromycin ophthalmic ointment:

• Wash your hands with soap and water.
• Have a mirror ready so that you can see your eye.
• Tilt your head back slightly.
• Gently pull down your lower eyelid to create a small pocket between the eye and the lower lid.
• Hold the ointment tube with the tip pointing toward this pocket. Hold it close enough so that the ointment goes into the eye, but not close enough to touch the eye.
•  Look up and away from the tip.
• Squeeze out a small amount of ointment into the lower eyelid pocket without touching the tip of the tube to your eye. Usually about 1 cm, which is a bit less than half an inch of ointment, is enough, but follow your healthcare provider’s instructions on the amount.
• Gently close your eye and then keep it closed for one or two minutes so the medicine can be absorbed.
• Gently use a clean tissue to wipe excess ointment from your eyelashes. Do not push, put pressure, or rub your eye.
• Replace the cap immediately after use.

It's important that you use erythromycin ointment until you finish the prescription, even if you feel better. If you stop using the medicine too soon, your infection may not be completely cured and the bacteria may become resistant to antibiotics.

Make sure the cap is tightly closed on the ointment tube, and keep out of reach of children. Store the tube at room temperature and away from moisture. Do not freeze the ointment.

Side Effects of Erythromycin Eye Ointment

Common

While using erythromycin ophthalmic ointment, you may experience common side effects such as:

• Redness
• Stinging
• Burning
• Temporary blurred vision

Prolonged use of erythromycin eye ointment may lead to fungal infections, probably because the antibiotic removes the normal microorganisms in the eye. Tell your healthcare provider if you notice new eye symptoms or if your eye symptoms are getting worse.

Severe Reactions

Severe allergic reactions to erythromycin eye ointment are rare, but they do happen. Call your healthcare provider immediately if you experience any symptoms of an allergic reaction, including:

• Rash
• Hives
• Difficulty breathing
• Itching
• Swelling of the face, tongue, or throat

Warnings and Interactions

Drugs and supplements may interact with each other. Therefore, when your healthcare provider prescribes an antibiotic eye ointment, it's important to be clear about all the over-the-counter and prescription medications you are taking.

In rare instances, erythromycin can negatively affect the liver, but that has only been found to be the case in oral erythromycin and not the ointment. Still, it's worth letting your healthcare provider know about everything you are taking.