Clarithromycin: a new perspective in rosacea treatment

International Journal of Dermatology, Volume 37 Issue 5 Page 347 – May 1998, Claudio Torresani MD.

Biaxin (Clarithromycin) is a recently synthesized macrolide antibiotic that has shown anti-inflammatory actions.

In his 1998 paper Clarithromycin: a new perspective in rosacea treatment, renowned rosacea researcer Dr. Claudio Torresani concludes that “Clarithromycin can be considered to be a drug of primary importance in the treatment of rosacea”.

His study of clarithromycin and rosacea started in 1992 when a patient with follicultis of the legs had unexpected improvement with her rosacea symptoms when treated with biaxin. Further trials compared clarithromycin and doxycycline. Biaxin was shown to result in more consistent improvement compared to the doxycycline (vibramycin). (The dosages used in the trial were: clarithromycin 250mg twice daily for 4 weeks, followed by once daily for the following 4 weeks. For doxycycline: 100mg twice daily for 4 weeks and once daily for the following 4 weeks.)

It was shown that 6 weeks of biaxin was exquivalent to 8 weeks of vibramycin treatment. A followup study at 3 years showed that clarithromycin patients had able to reduce their treatment to an average of 10.2 weeks a year compared to 14.6 weeks for doxycycline.

The side effects were also pleasing. The side effects in both studies were “only occasional and very slight”. Dr. Torresani contrasts these mild side effects with tetracyclines and metronidazole, saying that clarithromycin “may be considered to be an extremely safe therapy”.

The final chapter discusses the possible pharmacologic action of this particular macrolide antibiotic. There is some discussion of helicobacter pylori but no conclusions are drawn.

Conclusions: Clarithromycin can be considered to be a drug of primary importance in the treatment of rosacea, and the cost of therapy is rewarded by the practical absense of side-effects and by the smaller doses on fewer overall days of treatment. We still do not understand exactly how the drug works, but considering its proven efficacy in rosacea treatment, it may be hoped that future studies will discover its hidden secrets.

• PubMed Extract
• Abstract Online (Full Paper is available from the Author.)

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