chosen options for the treatment and management of acne. These topical antibiotics are available in several kinds of delivery vehicles and many sorts of packaging. Clindamycin and erythromycin have both shown effectiveness in cases of inflammatory cystic acne when used as a topical application of a combination of 1% to 4% concentrations with or without being combined with zinc. .
Topical clarithromycin, azithromycin, and nadifloxacin formulations continue to be available, but there are no validated clinical trials or research studies that clearly show their efficiency or safety.
Topical antibiotics used in the treatment of cystic acne act within the affected follicle through an anti-inflammatory and antibacterial activity. These drugs work best when they are utilized together with benzoyl peroxide (either wash-off or leave-on versions) that heightens their efficiency and reduces the potential development of resistant strains of acne bacteria. Only using topical antibiotics for the treatment and management of cystic acne is mostly not recommended due to the possibility of developing antibiotic resistance.
Combination formulations are known to improve the compliance of the patient in using the prescribed treatment protocols. There have been a few rare incidents of side effects with diarrhea or Clostridium difficile associated colitis following the use of topical clindamycin for the treatment of severe acne in some patients, but since these cases are quite rare, the potential risk of this side effect with the use of such topical combination formulations is quite low. In general, most people show a good degree of tolerance towards these combination antibiotic treatments for acne.
Topical antibiotics seem to be more suited to the treatment and management of mild and moderate acne. Even though their effectiveness continues to be average, they have been used for many years now. The efficiency of topical antibiotics used for treating acne has been examined in many research studies and clinical trials. Both antibiotics erythromycin and clindamycin have been shown to be moderately effective with patients showing a good degree of tolerance. However, there is a trend for decreasing sensitivity of the acne-causing bacteria P. acnes to these two antibiotics, which may limit the use of these antibiotics in the future.