A randomized, single-blind comparison of topical clindamycin + benzoyl peroxide (Duac) and erythromycin + zinc acetate (Zineryt) in the treatment of mild to moderate facial acne vulgaris

J Eur Acad Dermatol Venereol. 2007 Mar;21(3):311-9. doi: 10.1111/j.1468-3083.2006.01884.x.

Abstract

Background: Antibiotics are often combined with other agents to provide topical acne treatments that are effective against both inflammatory and non-inflammatory lesions and minimize the development of antibiotic resistance.

Objectives: To compare the clinical effectiveness of two combination treatments for facial acne: a ready mixed, once daily gel containing clindamycin phosphate (1%) plus benzoyl peroxide (5%) (CDP + BPO) and a twice daily solution of erythromycin (4%) plus zinc acetate (1.2%) (ERY + Zn).

Methods/patients: In this assessor-blind, randomized study, 73 patients were treated with CDP + BPO once daily and 75 patients with ERY + Zn twice daily. The treatment period was 12 weeks and lesion counts and global improvement were assessed at weeks 1, 2, 4, 8 and 12.

Results: CDP + BPO showed an earlier onset of action with a faster significant reduction in total lesion counts than ERY + Zn. The proportion of patients with at least a 30% improvement in non-inflammatory lesions at week 1 was 31.5% for CDP + BPO and 17.3% for ERY + Zn; the corresponding percentages for inflammatory lesions were 39.7% and 29.3%. A difference was also observed at week 2 (53.4% vs. 36.0% for non-inflammatory lesions and 72.6% vs. 53.3% for inflammatory lesions). The trend in favour of CDP + BPO, although less marked, continued to the end of the study, with reductions in the total lesion count at endpoint of 69.8% for CDP + BPO group and 64.5% for ERY + Zn group. Both treatments were well tolerated.

Conclusions: CDP + BPO and ERY + Zn are effective treatments for acne but CDP + BPO has an earlier onset of action that should improve patient compliance.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acne Vulgaris / drug therapy*
  • Administration, Topical
  • Adolescent
  • Adult
  • Anti-Bacterial Agents / administration & dosage*
  • Benzoyl Peroxide / administration & dosage*
  • Child
  • Clindamycin / administration & dosage*
  • Decanoic Acids / administration & dosage*
  • Dermatologic Agents / administration & dosage*
  • Drug Combinations
  • Erythromycin / administration & dosage*
  • Facial Dermatoses / drug therapy*
  • Female
  • Gels
  • Humans
  • Male
  • Single-Blind Method
  • Statistics, Nonparametric
  • Treatment Outcome
  • Zinc Acetate / administration & dosage*

Substances

  • Anti-Bacterial Agents
  • Decanoic Acids
  • Dermatologic Agents
  • Drug Combinations
  • Gels
  • clindamycin phosphate benzoyl peroxide combination
  • erythromycin, zinc acetate drug combination
  • Clindamycin
  • Erythromycin
  • Zinc Acetate
  • Benzoyl Peroxide