Treat Sinusitis With Erythromycin Ethyl Succinate

Erythromycin ethyl succinate (EES) is a macrolide antibiotic formulation used to treat impetigo when first-line antibiotics are not suitable — typically in patients with penicillin allergy. Erythromycin ethyl succinate is a specific salt form of erythromycin that is better absorbed when taken with food and is commonly used in oral suspension form for children. It works by inhibiting bacterial protein synthesis to clear the Staphylococcus aureus or Streptococcus pyogenes bacteria causing impetigo. Through the NHS Pharmacy First service, a pharmacist can supply this medication for impetigo without a GP visit.

Adults: 400 mg four times daily or 800 mg twice daily for 5–7 days. Children: the dose is weight-based, typically 40 mg/kg/day divided into four doses (or two doses if using the higher twice-daily regimen). Your pharmacist will calculate the appropriate dose. Erythromycin ethyl succinate should be taken with or after food to improve absorption and reduce stomach upset. Complete the full course to prevent recurrence.

Both are salt forms of the antibiotic erythromycin with the same antibacterial activity. The key differences are in absorption and dosing: erythromycin ethyl succinate should be taken with food (food improves absorption), while erythromycin stearate should be taken on an empty stomach. The doses also differ — 400 mg of erythromycin ethyl succinate is approximately equivalent to 250 mg of erythromycin base or stearate. Your pharmacist will prescribe the correct dose for the formulation supplied.

Yes, the NHS Pharmacy First service enables pharmacists to assess impetigo and supply appropriate antibiotics including erythromycin ethyl succinate, particularly for patients who cannot take penicillin-type antibiotics. The pharmacist will examine the affected area, confirm the diagnosis, and determine whether topical or oral treatment is needed. This service is free on the NHS and saves you waiting for a GP appointment.

Common side effects include nausea, vomiting, abdominal pain, diarrhoea, and loss of appetite. Erythromycin can cause stomach cramps due to its prokinetic effect on the gut. Taking it with food helps reduce gastrointestinal side effects. Uncommon side effects include hearing disturbance (usually reversible at high doses), skin rash, and liver function changes. Rare serious side effects include severe allergic reactions and QT prolongation. Stop the medication and seek medical advice if you develop jaundice, severe abdominal pain, or widespread rash.