Benzoyl peroxide 3% / Clindamycin 1% gel

Acne vulgaris is a common skin condition that significantly impacts both physical appearance and mental well-being. Acne, being a chronic skin condition, often requires continuous treatment. This study aims to evaluate the efficacy and safety of clindamycin phosphate 1.2%/benzoyl peroxide 3% compared to clindamycin phosphate 1.2%/adapalene 0.1% combinations for treating acne vulgaris. A systematic review and meta-analysis of randomized controlled trials were carried out following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and three databases were searched to identify RCTs comparing CLIN/BPO with CLIN/ADAP. Primary outcomes included treatment-emergent adverse events, inflammatory and non-inflammatory lesion counts, and application site side effects. Statistical analyses were conducted using RevMan 5.3. The study included a total of 800 participants across three RCTs. The meta-analysis of three RCTs demonstrated a significantly lower risk of TEAEs with CLIN/BPO (OR = 0.49, 95% CI: 0.35-0.86, p < 0.001). CLIN/BPO also resulted in fewer application site side effects (OR = 0.33, 95% CI: 0.23-0.47, p < 0.001). However, no significant differences were observed between the groups for reducing inflammatory (MD = 1.34, 𝑝 = 0.121) or non-inflammatory lesion counts (MD = 0.04, 𝑝 = 0.98). The study concluded that although CLIN/BPO was associated with fewer side effects, both treatments were equally effective in reducing acne lesions. The favorable safety profile of CLIN/BPO, particularly regarding treatment-emergent and application-site adverse events, suggests it may be the more tolerable option for patients. Future studies with larger, more diverse populations are recommended to confirm these findings and explore long-term efficacy.

Abstract licence: CC BY-NC-ND

BACKGROUND: Studies have found demographic differences in prescribing patterns for certain inflammatory conditions, including acne. OBJECTIVE: To investigate acne prescription patterns among patients seen in the private system (PS) and safety-net health care system (SNS) of the University of Southern California (USC). METHODS: This was a multisite, retrospective study of patients obtaining acne care at PS and SNS outpatient dermatology facilities in Los Angeles over a one-year period. RESULTS: Despite similar acne severity, SNS patients were less often prescribed azelaic acid, benzoyl peroxide/clindamycin, benzoyl peroxide/adapalene, sulfacetamide, topical dapsone, and salicylic acid than PS patients (p < 0.001). SNS patients received fewer prescriptions for oral medications including spironolactone, antibiotics, and isotretinoin (p < 0.001). Despite similar acne severity, non-White patients were less frequently prescribed topical retinoids (p = 0.003), benzoyl peroxide/clindamycin (p = 0.003), isotretinoin (p < 0.001) and spironolactone (p < 0.001) than White patients. Despite higher acne severity among Hispanics/Latinos, they were less often prescribed spironolactone and oral antibiotics than their non-Hispanic/Latino counterparts (p = 0.023). CONCLUSIONS: Findings from this study highlight differences in acne prescribing patterns by race/ethnicity and hospital system, which can impact the ability of patients to have successful treatment of their acne and its sequelae.

Abstract licence: CC BY

Background: Antibiotic resistance is growing globally, with multiple countries reporting resistance in > 50% of Cutibacterium acnes ( C. acnes ) strains. Combination formulations of an antibiotic and the antimicrobial benzoyl peroxide (BPO) may reduce this resistance risk, especially with prolonged use. This 4-part study tested susceptibility of 31 C. acnes clinical strains and development of resistance to antibiotics alone or combined with BPO. Methods: C. acnes susceptibility to single-drug antibiotics was assessed via minimum inhibitory concentration (MIC) values obtained from epsilometer tests, with lower MIC indicating higher susceptibility. Susceptibility to fixed-dose antibiotic/BPO combination products was determined by measuring the zone of inhibition using the agar diffusion method, with larger diameter indicating increased bacterial inhibition. The effect (synergistic, additive, antagonistic, or indifferent [no interaction]) of combining clindamycin with BPO on C. acnes inhibition was evaluated using a checkerboard assay, wherein 2 test compounds are combined in varying concentrations. Resistance development was assessed using serial passage of bacterial cultures in increasing concentrations of clindamycin alone or in combination with BPO. Results: All tested antibiotics (clindamycin, doxycycline, erythromycin, and minocycline) exhibited similar activity. C. acnes susceptibility was variable, with some strains having elevated MIC values—an indication of resistance—against different antibiotics. For 6 strains resistant to clindamycin alone (inhibitory zone=0 cm), formulations with BPO enhanced activity against the same isolates (range: 0.8– 2.2 cm). Of 7 acne-associated strains, combining clindamycin and BPO had an additive effect against 4, and no interaction against 3. Bacterial cultures repeatedly exposed to the combination of clindamycin and BPO did not develop antibiotic resistance, which occurred with exposure to clindamycin alone. Conclusion: Overall, antibiotic susceptibility was highly dependent on the C. acnes strain, and antibiotic formulations with BPO exhibited enhanced activity against less susceptible strains. Fixed combinations of BPO with an antibiotic may improve antimicrobial activity and protect against resistance development. Keywords: acne, antibiotics, benzoyl peroxide, clindamycin, combination treatment, C. acnes , resistance, susceptibility

Abstract licence: CC BY-NC

BACKGROUND: Acne vulgaris is an inflammatory disease affecting the pilosebaceous unit, which also has psychological effects. AIMS: Our aim in our study is to compare the recovery levels and side effect profiles of patients diagnosed with acne during pregnancy and who used topical erythromycin, clindamycin, or topical azelaic acid. METHODS: After ethical approval was obtained for the study, the files of patients who applied to the outpatient clinic with acne complaints in 2018-2022 were retrospectively examined, and the files of 75 pregnant patients who used topical erythromycin, 96 who used clindamycin, and 26 who used azelaic acid were included in the study. Pre- and post-treatment IGA values, lesion numbers, side effects during the treatment process, and patient satisfaction levels were examined. RESULTS: When the groups were compared in terms of IGA value at the end of treatment and percentage improvements in all lesion numbers, it was seen that there was more improvement in the group using azelaic acid than the others (p < 0.001 for both). When the groups were compared in terms of side effects, no difference was found (p = 0.093). When the groups were compared in terms of satisfaction levels, there were significantly more patients who were very satisfied in the azelaic acid group (p < 0.001). CONCLUSION: As a result of the study, we see that azelaic acid is more successful in terms of both effectiveness and patient satisfaction. Therefore, azelaic acid is a good option in the treatment of mild to moderate acne during pregnancy.

Abstract licence: CC BY