Topical erythromycin vs blank vehicle in a multiclinic acne study

Abstract

A stable solution of erythromycin was developed using a vehicle of ethanol, propylene glycol, and citric acid buffer. In a controlled, randomized, double-blind comparison, a 2% solution of erythromycin applied to moderately severe facial acne was found to be superior to the blank vehicle in reducing the number of inflamed papules. During a period of 12 weeks, such papules were reduced by 56% in the erythromycin group, compared with 33% in the blank vehicle group. In the erythromycin group, 62% of the subjects had a good or excellent response, compared with 27% of those in the blank vehicle group. Adverse effects were similar in type in both groups and included redness, scaling, dryness, oiliness, burning, itching, and irritation of the eyes. No allergic reactions or skin infections were encountered.

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

“…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).…”

Topical acne treatments in Europe and the issue of antimicrobial resistance

“…Clinical data show that erythromycin reduced the inflammatory lesion count by between 40-60%. [17][18][19] Clindamycin applied for 12 weeks provided similar results. [20][21][22][23][24][25] Disulone 5% was effective in mild-to-moderate acne reducing non-inflammatory, inflammatory and total lesion count by 19, 58 and 49% respectively, all were well tolerated.…”