Antibiotics Used in Dermatology, Their Method of Action, Indications, and Complications

Antibiotic group	Method of action	Antibiotic	Indications	Considerations
Penicillin's	Inhibition of bacterial cell wall synthesis Activation of autolytic bacterial enzymes Bactericidal ß lactamase resistant penicillin	Penicillin	Gram-positive infections, e.g. Streptococcus Cellulitis Erysipelas	Hypersensitivity reactions which may be severe Dose reduction in renal impairment
Penicillin's		Flucloxacillin	ß lactamase producing organisms, e.g. Staphylococcus aureus Cellulitis Impetigo	Hypersensitivity reactions
Macrolides	Penetration of bacterial cell wall and inhibition of RNA-dependent protein synthesis by reversible binding to ribosomes	Erythromycin	Gram-positive infections Penicillin allergy Cellulitis Erysipelas Impetigo Acne Erythrasm	Nausea, diarrhoea
		Clarithromycin	Gram-positive and gram-negative cover Erysipelas	Fewer gastrointestinal side effects
		Azithromycin	Short courses, long acting	Fewer gastrointestinal side effects
Tetracyclines	Inhibition of protein synthesis by ribosomal binding	Oxytetracycline Minocycline Doxycycline Lymecycline	Gram-positive and gram-negative organisms Mycobacteria Acne Rosacea Perioral dermatitis Bullous pemphigoid Lyme disease Fish tank granuloma	Nausea, vomiting. Brown discolouration of teeth and delayed bone growth in children. Contraindicated in children under 12 years Hypersensitivity reactions Blue-black pigmentation of nails and skin Photosensitivity