Topical clindamycin versus systemic tetracycline in the treatment of acne

Gratton, David; Gp, Raymond; S, Guertin-Larochelle; Maddin, SW; Leneck, CM; Warner, Judith E. A.; Collins, Jenny; Gaudreau, Philip; Bj, Bendl

doi:10.1016/s0190-9622(82)80009-1

Cited by 36 publications

(16 citation statements)

References 13 publications

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“…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] .…”

Section: Clinical Effi Cacymentioning

confidence: 68%

“…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...…”

Section: Pharmacokineticsmentioning

confidence: 99%

“…Topical clindamycin appeared to work as well as or superior to oral tetracycline or minocycline [17,[62][63][64][65][66] , topical tetracycline [67] , topical benzoyl peroxide [72] and topical erythromycin with/without zinc [67][68][69][70][71]74,75] .…”

Section: Clinical Effi Cacymentioning

confidence: 99%

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Topical clindamycin in the management of acne vulgaris

Guay

2007

Expert Opinion on Pharmacotherapy

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A small cadre of antimicrobials are commonly used and regarded as effective and safe, as systemic and topical treatments of acne vulgaris. These include oral tetracycline, doxycycline, minocycline and topical clindamycin and erythromycin. Topical antimicrobials work via both antimicrobial and non-antimicrobial mechanisms: the former due to suppression of the growth of propionibacterial species (especially Propionibacterium acnes and P. granulosum). Clindamycin appears to be superior in efficacy compared with erythromycin and tetracycline. However, the emergence and spread of resistance among propionibacteria to both erythromycin and clindamycin calls into question their long-term viability as topical anti-acne therapies. Only through judicious use of combination topical therapies (e.g., topical retinoid, benzoyl peroxide or azelaic acid plus clindamycin or erythromycin) and the practice of effective infection control (i.e., handwashing between seeing patients in the clinic) can both clindamycin's and erythromycin's widespread utility be preserved in this disorder.

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Section: Clinical Effi Cacymentioning

confidence: 68%

Section: Pharmacokineticsmentioning

confidence: 99%

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Topical clindamycin in the management of acne vulgaris

Guay

2007

Expert Opinion on Pharmacotherapy

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“…We identified 48 clinical trials investigating systemic tetracycline treatment efficacy in inflammatory acne, 29 trials investigating minocycline systemic treatment efficacy, 28,37,39,45,46,54, 10 trials investigating doxycycline systemic treatment efficacy 8,9,20,62,68,69,[81][82][83][84] and seven trials investigating lymecycline systemic treatment efficacy, 77,80,[85][86][87][88][89] 57 of which were included. 8,9,12,14,16,17,[19][20][21]23,[25][26][27][28][29][30][31][32][33][34][35][36][37][38]41,42,…”

Section: Literature Searchmentioning

confidence: 99%

Efficacy of tetracyclines in the treatment of acne vulgaris: a review

2007

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There is insufficient evidence to support one tetracycline rather than another in terms of efficacy. In the range of investigated dosages, the antibiotic dosage seems to have no impact on efficacy. Despite increased resistance to antibiotics, oral tetracycline formulations displayed no change in efficacy during the study period. Further studies are, however, required to determine if the anti-inflammatory properties of tetracyclines are sufficient in managing acne.

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“…The emergence of resistant organisms is also a problem (MARPLES and KLIGMAN 1971). When it is used topically as a 1 % solution the response is similar to that obtained with tetracycline 0.5 gjday (GRATTON et al 1982), but increased resistance amongst staphylococci and P. acnes is likely (EADY et al 1982a). Small amounts of clindamycin are absorbed during topical use (BARZA et al 1982), but nonetheless colitis is rare.…”

Section: Clindamycinmentioning

confidence: 98%

Pharmacology of the Skin II

1989

Handbook of Experimental Pharmacology

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PrefaceThe recent interest in the pharmacology of the skin and the treatment of its diseases has come about for two reasons. The first is a realisation that many aspects of pharmacology can be studied as easily in human skin as in animal models, where they may be more relevant to human physiology and disease. Examples of this are the action of various vasoactive agents and the isolation of mediators of inflammation after UV irradiation and antigen-induced dermatitis. The second reason is the fortuitous realisation that a pharmacological approach to the treatment of skin disease need not always await the full elucidation of aetiology and mechanism. For example, whilst the argument continued unresolved as to whether the pilo-sebaceous infection which constitutes acne was due to a blocked duct or to a simple increase in sebum production, 13-cis retinoic acid, was found quite by chance totally to ablate the disease; again, whilst cyclosporin, fresh from its triumphs in organ transplantation, has been found able to suppress the rash of psoriasis, it has resuscitated the debate on aetiology.We are therefore entering a new era in which the pharmacology and clinical pharmacology of skin are being studied as a fascinating new way of exploring questions of human physiology and pharmacology as well as for the development and study of new drugs, use of which will improve disease control and at the same time help to define pathological mechanisms.It was because of this burgeoning interest in pharmacology of skin and its diseases, that this book came about. Indeed it is long overdue and was planned several years ago; we console ourselves with the thought that the delay may have served to help define certain principles which were then only just emerging.The book is divided into two volumes which are independent but complementary; the first being an account of the general pharmacology of skin, the second volume being more concerned with disease and drugs. The first volume is divided into two parts, the one dealing with the pharmacology of skin systems and their control and the other with autocoids in normal and inflamed skin. This second volume has three parts; the first part deals with the methods of measurement which are becoming of increasing importance both in studying the pharmacological effects of drugs and the clinical pharmacology of skin; the second deals with toxicology in its widest sense -including metabolism and percutaneous absorption; and the third is an account both of specific drugs and the drugs used for specific diseases.

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Topical clindamycin versus systemic tetracycline in the treatment of acne

Cited by 36 publications

References 13 publications

Topical clindamycin in the management of acne vulgaris

Topical clindamycin in the management of acne vulgaris

Efficacy of tetracyclines in the treatment of acne vulgaris: a review

Pharmacology of the Skin II

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