Comparative efficacy of clindamycin and benzoyl peroxide for in vivo suppression of Propionibacterium acnes

BACKGROUND: Benzoyl peroxide and clindamycin are the two most widely prescribed topical antimicrobials in the treatment of acne. AIM: To compare the antimicrobial efficacy, in vivo, of benzoyl peroxide and clindamycin against Propionibacterium acnes. METHODS: Two groups of 10 subjects each, with comparable mean P. acnes baseline counts of log 5.75 to 5.85, underwent twice daily application of benzoyl peroxide or clindamycin for 14 days. RESULTS: The results of quantitatively sampling P. acnes after 3, 7 and 14 days of treatment showed that Triaz(TM) 6% benzoyl peroxide special gel produced faster and significantly greater reductions in P. acnes than did the 1% clindamycin phosphate in Cleocin-T(TM) lotion (p < 0.01). These results were paralleled by the greater reductions produced by Triaz versus Cleocin (p < 0.05) in P. acnes fluorescence. CONCLUSION: Benzoyl peroxide formulations suppress the follicular population of P. acnes more rapidly and to a greater degree than topical antibiotics such as clindamycin.