Topical metronidazole in the treatment of rosacea

Monk, Barry; Logan, Robert A.; Cook, John-Luke; White, John; Mason, R. B. S.

doi:10.3109/09546639109092728

Cited by 20 publications

(7 citation statements)

References 8 publications

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“…[15]. Similar results were also noted in a 9-week double-blind study evaluating 0.75% metronidazole gel versus oral oxytetracycline 500 mg daily [16]. At the study end point, complete clearance was achieved in 75% of patients treated with topical metronidazole and 66% of patients treated with oxytetracycline.…”

Section: Efficacysupporting

confidence: 70%

Medical treatment of rosacea with emphasis on topical therapies

Rosso

2004

Expert Opinion on Pharmacotherapy

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Due to the development and release of newer topical formulations, the diagnosis and treatment of rosacea has received renewed attention over the past 3-5 years both in the literature and at medical symposia. Rosacea is a very common facial dermatosis. In the US, rosacea is estimated to affect > 14 million people, predominantly adults with approximately 60% of cases diagnosed before the age of 50. A frustrating aspect of the disease is its inherent chronicity punctuated with periods of exacerbation and relative remission. A variety of subtypes have been identified which correlate with clinical presentation. Although the pathogenesis of rosacea is poorly understood, multiple topical agents are available. The efficacy of topical therapy for rosacea relates primarily to reduction in inflammatory lesions (papules, pustules), decreased intensity of erythema, a reduction in the number and intensity of flares and amelioration of symptoms, which may include stinging, pruritus and burning. The list of main topical agents utilised for the treatment of rosacea include metronidazole, sulfacetamide-sulfur, azelaic acid and topical antibiotics (clindamycin, erythromycin). Depending on the severity at initial presentation, topical therapy may be combined with systemic antibiotic therapy (e.g., oral tetracycline derivative). Newer therapeutic choices primarily involve improved vehicle formulations, which demonstrate favourable skin tolerability and cosmetic elegance.

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Section: Efficacysupporting

confidence: 70%

Medical treatment of rosacea with emphasis on topical therapies

Rosso

2004

Expert Opinion on Pharmacotherapy

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“…Four studies compared topical metronidazole and oral (oxy)tetracycline, but pooling of data was not possible due to clinical heterogeneity between the studies 59–62 . Although the quality of reporting of these studies was poor they did nevertheless indicate that there was no statistically significant difference in effectiveness between metronidazole cream and (oxy)tetracycline.…”

Section: Resultsmentioning

confidence: 99%

Effective and evidence‐based management strategies for rosacea: summary of a Cochrane systematic review

Zuuren

Kramer

Carter

et al. 2011

British Journal of Dermatology

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Summary Rosacea is a common chronic skin disease affecting the face. There are numerous treatment options, but it is unclear which are the most effective. The aim of this review was to assess the evidence for the efficacy and safety of treatments for rosacea. Searches included the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index, and Ongoing Trials Registers (updated February 2011). Randomized controlled trials in people with moderate to severe rosacea were included. Fifty‐eight trials, including 27 from the original review, comprising 6633 participants were included in this updated review. Interventions included topical metronidazole, oral antibiotics, topical azelaic cream or gel, topical benzoyl peroxide and/or combined with topical antibiotics, sulphacetamide/sulphur, and others. There was some evidence that topical metronidazole and azelaic acid were more effective than placebo. Two trials indicated that doxycycline 40 mg was more effective than placebo. There was no statistically significant difference in effectiveness between doxycycline 40 mg and 100 mg but there were fewer adverse effects. One study reported that ciclosporin ophthalmic emulsion was significantly more effective than artificial tears for treating ocular rosacea. Although the majority of included studies were assessed as being at high or unclear risk of bias, there was some evidence to support the effectiveness of topical metronidazole, azelaic acid and doxycycline (40 mg) in the treatment of moderate to severe rosacea, and ciclosporin 0·05% ophthalmic emulsion for ocular rosacea. Further well‐designed, adequately powered randomized controlled trials are required.

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“…Metronidazole 1% cream, Metronidazole 0.75% gel, lotion and cream Topical metronidazole, available either as a gel or a cream, is the most popular topical agent for treating rosacea. Metronidazole 0.75% gel 22,[27][28][29] and metronidazole 1% cream, 14,23,25,[30][31][32][33][34][35][36][37] metronidazole 0.75% cream 35,38 and metronidazole lotion 39 have been shown to be effective in treating rosacea when applied once or twice daily for 8-12 weeks. The results of these studies have demonstrated that both preparations significantly decrease the number of inflammatory lesions and reduce the erythema associated with rosacea.…”

Section: Topical Treatmentsmentioning

confidence: 99%