metrogel, metrolotion, metrocream, noritate, once and twice per day - all the same same

Despite quite a lot of activity in the marketing and development of the metronidazole treatments (lotion, cream, gel, generic equivalents, metrogel 1%, once per day, twice per day) this research suggests that the formulation and treatment frequency make little difference to the treatment outcome. So if you can tolerate one of the available formulations, there is likely marginal benefit from changing to another.

Metronidazole in the treatment of rosacea: do formulation, dosing, and concentration matter?

Yoo J, Reid DC, Kimball AB., Clinical Unit for Research Trials in Skin, Harvard Medical School, Boston, MA 02114, USA.

BACKGROUND: Topical metronidazole is commonly used in the management of rosacea. No consensus on the optimal formulation, concentration, or dosing regimen exists.

PURPOSE: To assess the relative efficacy of metronidazole cream, gel, and lotion at concentrations of 0.75% and 1%, in dosing regimens of once and twice daily.

METHODS: A meta-analysis of published metronidazole efficacy rates was performed.

RESULTS: In non-weighted analysis, the mean efficacy was 28.2% (95% confidence interval [CI], 22.0%-34.4%) for the cream, 38.4% (95% CI, 18.4%-58.4%) for the gel, and 35% for the lotion. Confidence intervals for QD versus BID dosing and 0.75% versus 1% concentrations also overlapped. In weighted analysis, the mean reduction was 31.3% for the cream, 22.1% for the gel, and 35% for the lotion.
CONCLUSIONS: Metronidazole cream, gel, and lotion vehicles have similar efficacies. There were no substantial differences between concentrations of 0.75% and 1%, or between once daily and twice daily regimens.

• PubMed Extract
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