Topical clindamycin therapy for acne vulgaris. A cooperative clinical study

Abstract

Eleven institutions participated in an eight-week controlled clinical study to evaluate treatment of acne vulgaris with topical clindamycin hydrochloride and clindamycin phosphate. Three hundred fifty-eight patients with comparable baseline pustule, papule, and nodule counts applied 1%, clindamycin hydrochloride, 1% clindamycin phosphate, or a hydroalcoholic vehicle twice daily. Every two weeks, lesions were counted, and patients' evaluations of their acne conditions were scored. By week 8, pustule and papule counts in the groups who were receiving clindamycin were significantly lower than those in the group receiving placebo. Also, more patients who were receiving clindamycin thought their acne improved by week 8 (with significantly higher change-in-acne scores) than did the patients receiving placebo. Patients receiving clindamycin reported 12 episodes of diarrhea; only one episode was considered to be treatment related. These results substantiate the clinical impression that topical clindamycin is effective treatment for acne.

Topical clindamycin in the management of acne vulgaris

“…As might be expected, topical clindamycin was statistically superior to placebo in lesion count reductions and investigator/patient assessments in all 18 trials [16,39,47,[49][50][51]55,56,58,59,63,79,80,85,90,91] . The vehicle and the salt form (hydrochloride versus phosphate) did not affect efficacy [52,55,57] .…”

“…Bioavailability from a 1% foam formulation was similar to or less than that from a 1% gel formulation [47] . Tables 2, 3 , and 4 illustrate English language clinical trial data for open or clindamycin-/vehicle-controlled trials [16,[47][48][49][50][51][52][53][54][55][56][57][58][59][60][61] , monotherapy versus non-clindamycin monotherapy trials [17,[62][63][64][65][66][67][68][69][70][71][72][73] , and monotherapy versus combination therapy trials [39,[74][75][76][77][78][79][80][81][82][83][84][85][86][87][88][89][90][91][92...…”

“…The vehicle and the salt form (hydrochloride versus phosphate) did not affect efficacy [52,55,57] . Two trials demonstrated equivalent results when clindamycin was applied once or twice daily [59,61] .…”

Guidelines of care for acne vulgaris management

“…Both erythromycin 52-58 and clindamycin [59][60][61][62][63][64][65][66] have been demonstrated to be effective and are well tolerated. Decreased sensitivity of P acnes to these antibiotics can limit the use of either drug as a single therapeutic agent.…”

Physicochemical characterization and skin permeation of liposome formulations containing clindamycin phosphate

“…Among antibiotics, clindamycin phosphate (CP) is generally considered the most effective for the treatment of acne because of its ability to inhibit the growth of Propionibacterium acnes, the primary pathogen of the disease (Becker et al, 1981;Guay, 2007). However, topical use of CP is often ineffective due to its difficulty in permeating the stratum corneum layer of the skin (Akhavan and Bershad, 2003).…”