Topical antibacterial therapy for acne. Study of the family of erythromycins

Treatment of acne with topical antibiotics: lessons from clinical studies

“…The most commonly reported objective outcome measures were decrease in inflammatory lesions and decrease in noninflammatory lesions (Table 1). Although lesion count can vary significantly between investigators in different trials, this was also the only objective outcome measure reported in older 9,47 and more recent studies, making comparison across clinical trials possible. Of the 50 eligible controlled trials identified in this study, 45 (90%) incorporated a lesion count.…”

“…Of the 50 eligible controlled trials identified in this study, 45 (90%) incorporated a lesion count. There were 22 double‐blind intention‐to‐treat studies, 20–24,31,34,37–39,50,54–57,61,64,65,71,72,74,77 10 placebo‐controlled trials, 9,14–16,19,26,29,44,47,60 12 single‐blind trials 27,28,33,58,59,62,63,66,69,70,73,76 and one open, randomized trial 51 . Studies evaluating the effect of topical erythromycin are summarized in Table 2 and those evaluating clindamycin in Table 3.…”

“…The duration of treatment varied between 8 weeks 9,14 , 22,29 , 38 and 12 weeks 15,16,19–21,24,26,27,31,34,39,44 for erythromycin (Table 2) and between 8 weeks 47,50 , 51 , 54–57,65 and 16 weeks 74 for clindamycin (Table 3). The most common trial duration was 12 weeks (67% of the studies for erythromycin and 50% of the studies for clindamycin).…”

“…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 …”

Benzoyl peroxide versus topical erythromycin in the treatment of acne vulgaris

“…The original study on topical erythromycin by Fulton & Pablo (1974) demonstrated a 39% reduction in non-inflamed lesions after 8 weeks therapy with 2% (w/v) erythromycin. Feucht et al (1980) found a significant reduction in non-inflamed lesions with topical 4% (w/v) erythromycin/zinc liquid after 10 weeks, but not with 4% (w/v) erythromycin/zinc gel.…”