Comparison of topical erythromycin 1.5 percent solution versus topical clindamycin phosphate 1.0 percent solution in the treatment of acne vulgaris

Commercial topical solutions of erythromycin 1.5 percent and clindamycin phosphate 1.0 percent were evaluated in a randomized, double-blind, twelve-week comparison in sixty-six patients with moderate acne. Both treatment groups showed significant reductions of total lesions, inflammatory lesions, and papules. Additionally, the group using erythromycin 1.5 percent showed significant decreases in total noninflammatory lesions and closed comedones, and the group using clindamycin phosphate 1.0 percent showed significant reductions in pustules. The only statistically significant differences between the treatments were the greater reductions in closed comedones for those patients using erythromycin 1.5 percent and greater reductions in pustules for those patients using clindamycin 1.0 percent. Nearly two thirds of the patients in each group had a good or excellent overall response after twelve weeks. One erythromycin-treated patient discontinued treatment because his wife became sensitized to it. This reportedly also occurred with the use of topical clindamycin. Other side effects were minor or transient. In this study, topical erythromycin 1.5 percent and clindamycin 1.0 percent appeared to be clinically equivalent for treating moderate facial acne.