Comparative study between topical clindamycin solution (1%) versus combination of clindamycin (1%)/adapalene (0.1%) gel in the treatment of mild to moderate acne vulgaris
Background and objective: Acne vulgaris is a common skin disorder. Combination therapy with topical retinoid and antibiotic is recognized as an effective treatment of acne vulgaris. The aim of this study was to compare the efficacy and tolerability of topical clindamycin solution as a monotherapy with the combination gel of clindamycin/adapalene for the treatment of mild to moderate acne of the face.
Methods: This comparative therapeutic trial was conducted at the out patient department of Dermatology and Venereology at Rizgari Teaching Hospital in Erbil City from November 2008. Hundred patients with mild to moderate acne of the face were enrolled in the study and were divided in to two groups; group I (n=50); apply clindamycin phosphate solution 1%, and group II (n=50); apply a combination gel of clindamycin1% /adapalene 0.1%; once daily at night for 12 weeks.
Results: Of 100 patients, 89 patients completed their treatment as per protocol, 45 patients in group I, and 44 patients in group II. At the end of the 12 weeks; the mean percent reductions of noninflammatory, inflammatory, and total lesion count were greater in group II than in group I. A significantly greater reduction of total (P = 0.008), and noninflammatory lesions (P = 0.002) were seen in group II than in group I. Both treatments were well tolerated, and few side effects were reported.
Conclusion: This study demonstrates that the combination of topical clindamycin and adapalene is more effective than clindamycin solution alone, and provides faster benefit in treatment of mild to moderate acne.
Simpson NB, Cunliffe WJ . Disorders of the Sebaceous glands. In: Burns T, Breathnach S, Cox N, Griffiths C editors. Rook's Textbook of Dermatology; 7th edition. Oxford: Black well scientific Publication; 2004. 43:15-42.
Kubba R, Bajaj AK, Thappa DM, Sharma R, Vedamurthy M, Dhar S, et al . Acne in india: Guidelines for management: Pathogenesis of acne. Indian J Dermatol Venereol Leprol 2009a; 75(1):S5-9.
The Evaluator's Global Severity Score (proposed at the Division of Dermatology Advisory Committee [DODAC] meeting of November 4 and 5, 2002).
Zaenglein AL, Graber EM, Thiboutot DM, Strauss JS.AcneVulgaris and Acneiform Eruptions. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ editors. Fitzpatrick's Dermatology in General Medicine; 7th edition. New York: McGraw-Hill; 2008.P.690-703.
Piskin S, Uzunali E . A review of the use of adapalene for thetreatment of acne vulgaris. PubMed Central: Ther Clin Risk Manag 2007; 3(4):621-4.
Habif T.P.Acne, Rosacea, and Related Disorder. In: Clinical Dermatology; 4th Edition. Philadelphia: Mosby; 2004. P.162-94.
Bowman S, Gold M, Nasir A, Vamvakias G .Comparison of clindamycin/benzoyl peroxide, tretinoin plus clindamycin, and the combination of clindamycin/benzoyl peroxide and tretinoin plus clindamycin in the treatment of acne vulgaris: a randomized, blinded study. J Drugs Dermatol 2005;4(5):611-8.
Dos SK, Barbhuiya JN, Jana S, Dey SK. Comparative evaluation of clindamycin phosphate 1% and clindamycin phosphate1% with nicotinamide gel 4% in the treatment of acne vulgaris. Indian J Dermatol Venereol Leprol 2003; 69: 8-9.
Jain GK, Ahmed FJ. Adapalene pretreatment increases follicular penetration of clindamycin: In vitro and in vivo studies. Indian J Dermatol Venereol Leprol 2007; 73: 326-9.
Wolf JE, Kaplan D, Kraus SJ, Loven KH, Rist T, Swinyer LJ, et al. Efficacy and tolerability of combined topical treatment of acne vulgaris with adapalene and clindamycin: a multicenter, randomized, investigator-blinded study. J Am Acad Dermatol 2003; 49:S211-7.
Zhang JZ, Li LF, Tu YT, Zheng J. A successful maintenance approach in inflammatory acne with adapalene gel 0.1% after an initial treatment in combination with clindamycin topical solution 1% or after mono-therapy with clindamycin topical solution 1%. J Dermatolog Treat 2004; 15(6): 372-8.
Nilfroushzadeh MA, Siadat AH, Baradaran EH, Moradi S. Clindamycin lotion alone versus combination lotion of clindamycin Phosphate plus tretinoin versus combination lotion of clindamycin phosphate plus salicylic acid in the topical treatment of mild to moderate acne vulgaris: A randomized control trial. Indian J DermatolVenereol Leprol 2009; 75: 279-82.
Caron D, Sorba V, Clucas A, Verschoore M . Skin tolerance of adapalene 0.1% gel in combination with other topical antiacne treatments. J Am Acad Dermatol 1997; 36(6 pt 2):S113-5.
The copyright on any article published in Zanco J Med Sci is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).