Over-the-counter acne lotion as effective as prescribed antibiotics
Treatment regimens
· Oxytetracycline (500mg twice daily) plus topical placebo cream
(applied twice daily)
· Minocycline (100mg sustained release formulation, once daily)
plus topical placebo cream (applied twice daily)
· Placebo tablet (once daily) plus topical 5 per cent benzoyl peroxide
(twice daily)
· Placebo tablet (once daily) plus topical 5 per cent benzoyl peroxide
with 3 per cent erythromycin (twice daily)
· Placebo tablet (once daily) plus topical 2 per cent erythromycin
(in the morning) and 5 per cent benzoyl peroxide (in the evening) |
Over-the-counter benzoyl peroxide lotion is as good as prescribed antibiotics for the treatment of mild to moderate facial acne, according to a new study.
Hywel Williams and colleagues from Nottingham and Leeds universities
compared five treatments for acne (see Panel right) in a trial involving
649 participants.
For all regimens, most improvement occurred during the first six weeks
of treatment, with almost 50 per cent of participants in each group reporting
at least moderate improvement in facial acne.
Differences in efficacy were small and the researchers report that the
most expensive regimen (modified-release minocycline) was not found to
be superior to the other treatments tested.
Professor Williams said: “Differences in cost-effectiveness between
regimens were large; the cheapest treatment (benzoyl peroxide) was 12
times more cost-effective than minocycline. We found that clinical efficacy
of oral tetracyclines is compromised by pre-existing propionibacterial
resistance. By contrast, topical regimens that included erythromycin
and benzoyl peroxide were unaffected by resistance but were not superior
to benzoyl peroxide alone.”
The researchers point out that since the study was completed topical
retinoids have become more popular treatments for acne. Independent cost-effectiveness
comparisons of topical retinoids and benzoyl peroxide, alone and in combination,
are now needed, they conclude (Lancet 2004;364:2188). |
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