Chlamydia pneumoniae (Cpn) and azithromycin

Written by on April 3, 2007 in macrolides with 1 Comment

As a followup to the recent note pathogen infection (Chlamydia pneumoniae) cause theory, comes a recently published paper, the first to address Cpn and Rosacea. This paper is very preliminary, but at least now Cpn is on the map. When a paper ends with “preliminary data suggest the need for further investigation” it means that the research can still go in any direction – confirming, negating or even obscuring the theory.

The role of Chlamydia pneumoniae in the etiology of acne rosacea: response to the use of oral azithromycin. Cutis. 2007 Feb;79(2):163-7, Fernandez-Obregon A, Patton DL, Hudson Dermatology and Skin Cancer Center, Hoboken, New Jersey, USA.

Acne rosacea is a chronic skin disorder that requires long-term therapy. Oral azithromycin has been used successfully to treat acne vulgaris, an observation that suggested an infectious agent may play an active role in the etiology of this disorder.

Ten adults (not previously reported) with acne rosacea were selected to be treated with oral azithromycin. Nine of the 10 subjects received 250 mg 3 times weekly for periods ranging from 5 to 19 weeks, at which time follow-up examinations were performed on 8 of the 9 treated subjects: 1 subject was lost to follow-up.

Prior to therapy. C pneumoniae antigen was detected in malar biopsy specimens in 4 of 10 subjects by immunoperoxidase technique (using monoclonal antibody to C pneumoniae). Serum antibodies against C pneumoniae were detected in 8 of 10 intent-to-treat subjects. Using polymerase chain reaction, C pneumoniae was not detected in peripheral blood mononuclear cells. The inflammatory response in tissues was characterized by a widespread infiltration of polymorphonuclear neutrophil cells, lymphocytes, and plasma cells, which support the clinical diagnosis of acne rosacea.

Nine of 10 subjects treated with azithromycin showed moderate to marked improvement of their acne rosacea. No adverse reactions to azithromycin occurred. and the drug appeared to be safe and effective. These preliminary data suggest the need for further investigation with clinical trials to study long-term tolerability and efficacy and also strongly implicate C pneumoniae in the pathogenesis of acne rosacea.

In late 2005, Dan pointed out a similar 2002 paper also talking about a possible link between Rosacea and Chlamydia pneumoniae. This paper was cited as a reference in Report on the 6th International Conference on the Macrolides, Azalides, Streptogramins, Ketolides & Oxazolidinones.

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About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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1 Reader Comment

  1. Eric says:

    Will Rosacea continue to show marked improvement after the azithromycin is discontinued?

    Will the CPN infection be eliminated?

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