Topical clindamycin treatment of acne. Clinical, surface lipid composition, and quantitative surface microbiology response

Abstract

A double-blind study has been conducted to examine the effect of topical 1% clindamycin hydrochloride hydrate in a hydroalcoholic vehicle as compared to the effect of the vehicle alone. Fourteen patients applied clindamycin or vehicle alone twice daily for eight weeks. Free fatty acid surface lipid percentages, quantitative bacterial counts, and clinical response were assessed every two weeks. A significant reduction (88%) in the percentage of free fatty acids in the surface lipids was seen in the clindamycin-treated group and not in the vehicle-treated group. There was no significant change in the surface microflora. Despite the short duration of treatment, objective clinical improvement was seen in three of nine treated patients, while none was observed in the placebo-treated patients.

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...…”

A diversity profile of the human skin microbiota

“…A role for microbes in skin disease has long been hypothesized (Holland et al 1977;Thomsen et al 1980;Till et al 2000;Paulino et al 2006). The tools and knowledge are now in hand to examine this role, potentially opening the door to new strategies for the diagnosis, prevention, and treatment of disease.…”

“…Many lines of evidence suggest a role for microorganisms even in noninfectious skin diseases, such as atopic dermatitis (AD; eczema), rosacea, psoriasis, and acne (Holland et al 1977;Thomsen et al 1980;Till et al 2000;Paulino et al 2006). Resident microbiota may become pathogenic, sometimes in response to an impaired skin barrier (Roth and James 1988).…”

Microbial Ecology of Human Skin in Health and Disease

“…The condition is associated with androgen exposure and puberty. Numerous studies have con®rmed that patients treated with antibiotics tend to experience acne remission; however, this response does not consistently correlate with changes in the micro¯ora of the skin as determined by cultivation (e.g., P. acnes counts) (Holland et al, 1977;Thomsen et al, 1980;Al-Mishari, 1987;Till et al, 2000). Weeks to months of antibiotic therapy are required to induce a response.…”