A / t / s

Name: A / T / S

What should I discuss with my healthcare provider before using A/T/S (erythromycin topical)?

You should not use erythromycin topical if you are allergic to it.

FDA pregnancy category C. It is not known whether erythromycin topical will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Erythromycin topical can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not use this medicine on a child younger than 18 years old without the advice of a doctor.

How should I use A/T/S (erythromycin topical)?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Do not use erythromycin topical to treat any skin condition that has not been checked by your doctor.

Wash your hands before and after using this medicine.

Clean and dry the skin area before you apply erythromycin topical. Spread the medicine on lightly, without rubbing it in.

Erythromycin topical is usually applied once or twice daily. Follow your doctor's instructions.

It may take up to 12 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 6 weeks of treatment.

Store at room temperature away from moisture and heat. Keep the tube or bottle tightly closed when not in use.

The gel form of this medicine is flammable. Do not use near high heat or open flame.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

A/t/s Interactions

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

  • Other antibiotics
  • Anticoagulants, such as warfarin (Coumadin)
  • Astemizole (Hismanal)
  • Carbamazepine (Tegretol)
  • Cisapride (Propulsid)
  • Clozapine (Clozaril)
  • Colchicine
  • Cyclosporine (Neoral, Sandimmune)
  • Digoxin (Lanoxin)
  • Disopyramide (Norpace)
  • Ergotamine
  • Felodipine (Plendil)
  • Lovastatin (Mevacor)
  • Phenytoin (Dilantin)
  • Pimozide (Orap)
  • Terfenadine (Seldane)
  • Theophylline (Theo-Dur)
  • Triazolam (Halcion)
  • Verapamil (Calan, Verelan)

This is not a complete list of erythromycin drug interactions. Ask your doctor or pharmacist for more information.

A/t/s Precautions


Serious side effects have been reported with erythromycin including the following:

  • Severe skin rash
  • Itching
  • Hives
  • Difficulty breathing or swallowing
  • Wheezing
  • Yellowing of the skin or eyes
  • Dark skin
  • Pale stools
  • Unusual tiredness
  • Vaginal infections



Serious side effects have been reported with erythromycin including the following:

  • Irritation at the site of application, including dryness, redness, itching, and burning
  • Redness, itching, stinging, or burning of the eye

Ophthalmic erythromycin can also cause blurred vision. Do not drive or operate heavy machinery until you know how erythromycin affects you.



Serious side effects have been reported with erythromycin including the following:

  • Cardiac complications, including QT prolongation and ventricular arrhythmias
  • Allergic reactions with skin reactions ranging from mild rash to widespread redness, necrosis, and detachment of the epidermis


Do not take erythromycin if you:

  • are allergic to erythromycin or to any of its ingredients
  • are taking terfenadine (Seldane)
  • are taking astemizole (Hismanal)

A/t/s and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Erythromycin falls into category B.

There are no well-done studies that have been done in humans with erythromycin. In animal studies, pregnant animals were given this medication, and the babies did not show any medical issues related to this medication.

A/t/s and Lactation

Tell your doctor if you are breastfeeding or plan to breastfeed.

Erythromycin has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from erythromycin, a choice should be made whether to stop nursing or to stop use of this medication. The importance of the drug to the mother should be considered.

For the Consumer

Applies to erythromycin topical: topical gel/jelly, topical lotion, topical ointment, topical pad, topical powder, topical solution, topical swab

Along with its needed effects, erythromycin topical (the active ingredient contained in A / T / S) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Some side effects of erythromycin topical may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For erythromycin ointmentLess common
  • Peeling
  • redness
For erythromycin pledget (swab), topical gel, or topical liquid form More common
  • Dry or scaly skin
  • irritation
  • itching
  • stinging or burning feeling
Less common
  • Peeling
  • redness

For Healthcare Professionals

Applies to erythromycin topical: topical gel, topical ointment, topical solution, topical swab


Local side effects are the most commonly reported adverse effects of topical erythromycin, and have included dryness, burning, tenderness, pruritus, desquamation, erythema, and oiliness. A single case of generalized urticarial reaction has been reported.[Ref]


Ocular side effects have included eye irritation.[Ref]

Some side effects of A / T / S may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Usual Pediatric Dose for Acne

<12 years: Safety and effectiveness have not been established.
>=12 years:
Gel: Spread gently over affected areas (without rubbing in) once or twice a day.

Ointment, solution, swabs: Apply to affected areas once or twice a day.

Areas to be treated should be cleansed prior to application. The duration of therapy depends on the response of the patient. Maximum response may not occur for up to 12 weeks.