Table 2. Systemic treatments for erythrasma.

g - gram; mg - milligrams; GI - gastrointestinal; MOA - mechanism of action; QID - four times per day; Tx - treatment

^aChloramphenicol is an antibiotic that was previously used to treat erythrasma. It inhibits peptidyl transferase, disrupting bacterial protein synthesis. An oral 250 mg dosage four times daily can lead to the resolution of erythrasma in 14 days. However, the side effects, which include aplastic anemia, bone marrow suppression, and encephalopathy, deter from its use currently [17].

Tx	Clarithromycin	Erythromycin	Tetracycline
Dose	1 g single dose.	250 mg QID for 14 days.	250 mg QID for 14 days.
MOA	Macrolide antibiotic that inhibits protein synthesis by binding the 50S ribosomal subunit.	Macrolide antibiotic that inhibits protein synthesis by binding the 50S ribosomal subunit.	Antibiotic that inhibits protein synthesis by binding the 30S ribosomal subunit.
Benefits	Effective, fewer GI adverse events compared to erythromycin, and single-dose treatment (encourages compliance).	Effective and safer than chloramphenicol.a	Effective and safer than chloramphenicol.a
Possible adverse effects	Abdominal cramps, allergic reaction, dyspepsia, hearing loss, metallic taste in mouth, neutropenia, and ventricular arrhythmias.	Abdominal pain, allergic reaction, cholestatic hepatitis, dyspepsia, hearing loss, Steven-Johnson syndrome, and ventricular arrhythmias.	Allergic reaction, esophagitis, hemolytic anemia, phototoxic reaction, renal toxicity, and tooth discoloration.
References	[8, 16, 17]	[8, 16, 17]	[8, 17]