Clinical Trial of Topical Erythromycin in Inflammatory Acne

Abstract

Sixty-nine informed subjects participated in a split-face, double-blind trial of topical erythromycin base 2% in Vehicle/N versus Vehicle/N alone. All subjects had grades II or III acne as described by Pillsbury. Study solutions were assigned to a randomly selected side of the subject's face. Solutions were applied twice daily. Inflammatory lesion counts were performed by the same investigator during the eight weeks of study at biweekly intervals. The difference in inflammatory lesion counts from beginning to end of study for each side of the face was compared utilizing Student's paired t-test. There was not a statistically significant difference in mean inflammatory lesions at the end of eight weeks (D = 1.46, t = 1.36, df 68). There was, however, a significant difference at two and six weeks (D = 2.59, t = 3.72, df 68; D = 1.41, t = 2.03, df 68). Observed differences in lesion counts were not considered to be clinically significant.

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

“…Superior efficacy against IL, compared with placebo, is observed with topical antibiotics (erythromycin 59,66,82–85,120–125 LE 1, clindamycin 58,72,76–79,126–133 LE 1, tetracycline 80,81,134 LE 1, nadifloxacin 135 LE 4), azelaic acid 45–47 (LE 1), BPO 48–56,58–60,136–140 (LE 1) and topical retinoids (adapalene 50,51,60–64 LE 1, isotretinoin 49,65,66,141 LE 1, tretinoin 67–75,133,142,143 LE 1).…”

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 …”

Optimization of Topical Erythromycin Formulations by Ion Pairing

“…In recent years, concerns about possible side effects of systemic antibi otics have led to the use of topical antibiotics for the treatment of acne vulgaris. ERY is one among the various topical antibiotics that have been studied and shown to be effective [5][6][7][8]. The main problem with topical ERY is its insufficient penetration into the different Dr skin layers and also into the lipids of the seba ceous follicles.…”