Acne vulgaris: double-blind trial comparing tetracycline and clindamycin

Abstract

A double-blind prospective study was undertaken to compare low-dosage tetracycline hydrochloride and clindamycin hydrate hydrochloride in the treatment of patients with pustular acne. Clinical improvement was noted in 93.7% of those receiving tetracycline and in 92.8% of those receiving clindamycin. Of those patients who were receiving clindamycin, two patients developed diarrhea and one patient developed pseudomembranous colitis. We conclude, therefore, that clindamycin should not be used as a primary drug in the treatment of acne.

Efficacy of tetracyclines in the treatment of acne vulgaris: a review

“…We identified 48 clinical trials investigating systemic tetracycline treatment efficacy in inflammatory acne, 11–58 29 trials investigating minocycline systemic treatment efficacy, 28,37,39,45,46,54,58–80 10 trials investigating doxycycline systemic treatment efficacy 8,9,20,62,68,69,81–84 and seven trials investigating lymecycline systemic treatment efficacy, 77,80,85–89 57 of which were included 8,9,12,14,16,17,19–21,23,25–38,41,42,44–52,54,56–58,62,66,69,71,72,75–81,83–88 . Trials were excluded for the following reasons: combination with other topical or systemic drug with antiacne efficacy, 18,53,55,64,68,73,74,82,89 use of obsolete drugs, 11,15,22 antibiotic treatment < 1 month prior to the study or selection of cases unresponsive to other antibiotics, 24,53,59,61,63,67,74 duplicate reports, 70 specific forms of acne (nodulocystic acne, 43,65 oil acne 40 ), cross‐over studies 13,18,39,60,63 …”

“…We identified 48 clinical trials investigating systemic tetracycline treatment efficacy in inflammatory acne, 29 trials investigating minocycline systemic treatment efficacy, 28,37,39,45,46,54, 10 trials investigating doxycycline systemic treatment efficacy 8,9,20,62,68,69,[81][82][83][84] and seven trials investigating lymecycline systemic treatment efficacy, 77,80,[85][86][87][88][89] 57 of which were included. 8,9,12,14,16,17,[19][20][21]23,[25][26][27][28][29][30][31][32][33][34][35][36][37][38]41,42,…”

Treatment of acne with topical antibiotics: lessons from clinical studies

“…We identify 35 clinical trials investigating topical erythromycin treatment efficacy in inflammatory acne 9–45 and 40 trials investigating topical clindamycin therapy 20,24,27,28,33,37,40,42,46–77 . Trials were excluded for the following reasons: combination with other topical or systemic drug with anti‐acne efficacy, 17,25,30,32,35,36,40,41,43,45,68,75 antibiotic treatment < 1 month prior to the study or selection of cases unresponsive to other antibiotics, 49 split‐face design studies, 18,48 , 52,53 determination of outcome on selected cases, 48 duplicate reports 67 …”

European Evidence‐based (S3) Guidelines for the Treatment of Acne

“…There is a trend towards comparable‐to‐superior efficacy for tetracycline compared with clindamycin 203,204 and erythromycin 205–207 (LE 4).…”