Erythromycin / Benzoyl Peroxide (Benzamycin)

Topical Antibiotic / Topical Antibacterial

Pregnancy

No adverse effects of topical erythromycin have been observed in animal studies. Erythromycin crosses the placenta when taken orally. When applied topically, only a small fraction of erythromycin enters the bloodstream. 

The effects of topical benzoyl peroxide have not been studied in pregnant animals. There are also no known studies in humans that have tested the safety of benzoyl peroxide in pregnancy. We only know that when benzoyl peroxide is applied to the skin, a small fraction of its components is absorbed and can be detected in the bloodstream. 

Category: C

Category A

Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).

Category B

Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.

Category C

Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Category D

There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Category X

Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.

Breastfeeding

Excretion into human milk: Unknown (for both topical erythromycin and benzoyl peroxide)

Low levels of erythromycin are found in breast milk after oral intake which are unlikely to cause side-effects. It is unknown if topical erythromycin is found in breast milk. Erythromycin can safely be given to infants. Therefore, erythromycin is acceptable during breastfeeding. 

Infants exposed to erythromycin may have a decreased appetite, diarrhea, rash or somnolence (sleepiness) so monitor the infant. 

Benzoyl peroxide seems to be of low risk to the infant when used topically while breastfeeding. Although topical benzoyl peroxide use during breastfeeding has not been studied, research suggests only a small fraction of the components of topically applied benzoyl peroxide is absorbed into the bloodstream. 

Do not apply erythromycin / benzoyl peroxide to the nipple area and make sure the infant’s skin does not come into contact with the areas of skin that have been treated with erythromycin / benzoyl peroxide. 

If you are breastfeeding, speak with your physician before you use erythromycin / benzoyl peroxide.

References
  1. MedlinePlus. (2018). Erythromycin and benzoyl peroxide [online]. Available at: https://medlineplus.gov/druginfo/meds/a603024.html. [Accesses 12 Sept. 2018].
  2. PubMed Health. (2018). Erythromycin and benzoyl peroxide. Available at: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0045181/. [Accessed 12 Sept. 2018].
  3. Uptodate.com. (2018). Erythromycin and benzoyl peroxide [online] Available at: https://www-uptodate-com.eresources.mssm.edu/contents/erythromycin-and-benzoyl-peroxide-drug-information?search=erythromycin%20benzoyl%20peroxide&source=search_result&selectedTitle=1~11&usage_type=default&display_rank=1. [Accessed 12 Sept. 2018].