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Medical Author:

Gary W. Cole, MD, FAAD

Gary W. Cole, MD, FAAD

Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Doctors may use antibiotics when the guttate psoriasis is related to a streptococcal infection. They may choose an antibiotic that will act on a wide range of bacteria. Always tell your doctor what drugs you are currently taking because of the possibility of drug reactions.

Erythromycin (EES, E-Mycin, Ery-Tab) reduces inflammation and is used to treat bacterial infections. The usual dosing is one tablet per day by mouth for about 7-14 days. People with allergies to erythromycin or who have liver problems should not take this drug. Discontinue use if nausea, vomiting, fatigue, intestinal cramping, or fever occurs.

Penicillin VK (Veetids, Beepen-VK) is used to treat bacterial infections. The usual dosing is one tablet per day by mouth for about 10-14 days. People with allergies to penicillin should not take this drug. Caution is taken with the dosing of this drug in those who have reduced kidney function.

Rifampin (Rifadin, Rimactane) is recommended for resistant cases of streptococcal infection. If the doctor thinks it is possible that the infection will last a long time and you may become a chronic carrier of the bacteria, he or she may prescribe this drug. Rifampin is usually given in addition to either erythromycin or penicillin. The drug is taken by mouth over the course of five days.

You should be aware of possible allergic reactions to any antibiotic used, especially penicillin. Stop taking the drug if an allergic reaction is suspected. Patients who are sensitive to penicillin generally do well on erythromycin. Cephalosporin is an antibiotic that can also be used for streptococcal infections, but some cross-sensitivity with penicillins has been documented.

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