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Re: Klaron vs Noritate

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I have used Klaron in the morning and Noritate at night for several

years, and VERY rarely do I ever get any papules or pustules- they

dont seem to have much effect on the redness however- N.

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Well, another thing about noritate (metonidazole) in regards to

acne. In addition to being an anti-inflammatory, it is an anaerobic

antibiotic and should have some effect on the anaerobic p. acnes.

Many times there is no rational theory behind combining two anti-

inflammatory antibiotics, and certainly generally not from an id

standpoint to reduce resistance because if you really wanted to

reduce resistance you'd use oral minocyline (which p. acnes are

resistant only to the tune of < 2%) or zithromax (unknown resistance

but certainly much less than erthro, doxy, tetra, bactrim, etc.)

I think it is kind of like throwing everything in and hoping

something will work.

I have a rational combination theory as follows. This is generally

for the inflammatory acne component of rosacea and rosaceans with

more inflammatory acne than erythema.

Use brevoxyl 4% gel hs or bid. This is an aqueous based gel which is

generally non irritating. Keep away from nose and nasolabial folds.

Using bp for a week or two reduces p. acnes by a great amount,

greater than oral antibiotics. Though you don't realize the anti

inflammatory effect which oral antibiotics are famous for. Then use

a q-tip and spot treat pustules with azeleic acid. Azelex picks up

the slack on the anti-inflammatory front, and adds an appreciable

comedolytic action to the inflammatory lesion. Using a q tip limits

the irritation to only the pustule.

Best part about this therapy -- no resistant p. acnes are selected

for.

For best results, as always, combine with a good oral therapy.

> I have used Klaron in the morning and Noritate at night for several

> years, and VERY rarely do I ever get any papules or pustules- they

> dont seem to have much effect on the redness however- N.

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Share on other sites

Guest guest

Well, another thing about noritate (metonidazole) in regards to

acne. In addition to being an anti-inflammatory, it is an anaerobic

antibiotic and should have some effect on the anaerobic p. acnes.

Many times there is no rational theory behind combining two anti-

inflammatory antibiotics, and certainly generally not from an id

standpoint to reduce resistance because if you really wanted to

reduce resistance you'd use oral minocyline (which p. acnes are

resistant only to the tune of < 2%) or zithromax (unknown resistance

but certainly much less than erthro, doxy, tetra, bactrim, etc.)

I think it is kind of like throwing everything in and hoping

something will work.

I have a rational combination theory as follows. This is generally

for the inflammatory acne component of rosacea and rosaceans with

more inflammatory acne than erythema.

Use brevoxyl 4% gel hs or bid. This is an aqueous based gel which is

generally non irritating. Keep away from nose and nasolabial folds.

Using bp for a week or two reduces p. acnes by a great amount,

greater than oral antibiotics. Though you don't realize the anti

inflammatory effect which oral antibiotics are famous for. Then use

a q-tip and spot treat pustules with azeleic acid. Azelex picks up

the slack on the anti-inflammatory front, and adds an appreciable

comedolytic action to the inflammatory lesion. Using a q tip limits

the irritation to only the pustule.

Best part about this therapy -- no resistant p. acnes are selected

for.

For best results, as always, combine with a good oral therapy.

> I have used Klaron in the morning and Noritate at night for several

> years, and VERY rarely do I ever get any papules or pustules- they

> dont seem to have much effect on the redness however- N.

Link to comment
Share on other sites

Guest guest

Well, another thing about noritate (metonidazole) in regards to

acne. In addition to being an anti-inflammatory, it is an anaerobic

antibiotic and should have some effect on the anaerobic p. acnes.

Many times there is no rational theory behind combining two anti-

inflammatory antibiotics, and certainly generally not from an id

standpoint to reduce resistance because if you really wanted to

reduce resistance you'd use oral minocyline (which p. acnes are

resistant only to the tune of < 2%) or zithromax (unknown resistance

but certainly much less than erthro, doxy, tetra, bactrim, etc.)

I think it is kind of like throwing everything in and hoping

something will work.

I have a rational combination theory as follows. This is generally

for the inflammatory acne component of rosacea and rosaceans with

more inflammatory acne than erythema.

Use brevoxyl 4% gel hs or bid. This is an aqueous based gel which is

generally non irritating. Keep away from nose and nasolabial folds.

Using bp for a week or two reduces p. acnes by a great amount,

greater than oral antibiotics. Though you don't realize the anti

inflammatory effect which oral antibiotics are famous for. Then use

a q-tip and spot treat pustules with azeleic acid. Azelex picks up

the slack on the anti-inflammatory front, and adds an appreciable

comedolytic action to the inflammatory lesion. Using a q tip limits

the irritation to only the pustule.

Best part about this therapy -- no resistant p. acnes are selected

for.

For best results, as always, combine with a good oral therapy.

> I have used Klaron in the morning and Noritate at night for several

> years, and VERY rarely do I ever get any papules or pustules- they

> dont seem to have much effect on the redness however- N.

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Guest guest

> I was on minocycline but when it seemed to lose its effectiveness,

I switched to

> doxcycline. You mention zithromax which I am not familiar with.

Is this a new

> drug for rosacea or one which has been around for awhile but is

less known than

> the tetracyclines? Do you take it every day and does it make you

photosensitive?

a, Zithromax (azithromycin) is another type of antibiotic, a

variant of erythomycin. All antibiotics work by the same proposed

anti-inflammatory mechanism. Its chief benefit is that it is easier

to maintain a good blood level because it is taken only once a day

and isn't inactivated by dairy products or antacids. It also does not

cause photosensitivity, and can be taken on an empty stomach. The

downside is that it is quite expensive, far more so than even

doxycycline, and has more potential side effects than does the

tetracyclines (although it is still a relatively safe drug). The

erythromycins as a group are less effective in most rosaceans than

are the tetracycles/doxycyclines, but if doxycycline doesn't work for

you it is an option to discuss with your doctor, especially if it's

inconvenient to take pills every 12 hours.

Marjorie

Marjorie Lazoff, MD

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Guest guest

For rosacea 500 mg zithro loading with 250mg qd thereafter is miles

ahead of the others. But you should try minocyline first because

that may work indefinately for you. At least try 100 mg Minocin or

generic equivalent bid before graduating to Zithromax. Save

Zithromax for when minocyline stops working or if you can't use

Accutane.

Int J Dermatol 2000 Jan;39(1):45-50 Related Articles, Books, LinkOut

Azithromycin for the treatment of acne.

Fernandez-Obregon AC.

Hudson Dermatology & Skin Center, Hoboken, NJ 07030, USA.

BACKGROUND: Acne affects a large number of young adults, including

women, who often present with facial as well as truncal involvement.

Systemic antimicrobial agents currently used for the reduction of

inflammatory papules and cysts require frequent administration and

are sometimes associated with uncomfortable side-effects contributing

to a decrease in compliance. METHODS: Ninety-nine episodes of

inflammatory acne in 79 patients treated with oral antimicrobial

agents were studied retrospectively over a period of 46 weeks.

Patients were treated with tetracycline, erythromycin, minocycline,

and doxycycline, the most commonly prescribed oral antimicrobials

used to treat acne. Individuals that were unable to tolerate this

therapy or had failed conventional therapy were treated with the

azalide antibiotic azithromycin, given in a single oral 250-mg dose

three times a week. The other agents were administered daily in

divided doses as is current practice. Patients were also on topical

care. RESULTS: The efficacy and reported side-effects were examined

for all agents. Significant improvement was noted in 4 weeks. All

agents were effective in reducing inflammatory lesions and improving

acne. Azithromycin produced a slightly higher percentage of patients

with a greater than 80% reduction in their inflammatory acne lesions

(85.7%) vs. an average of 77.1% for all other agents. All differences

observed were not statistically significant. CONCLUSIONS: The results

show that azithromycin is a safe and effective alternative in the

treatment of inflammatory acne with few side-effects and good

compliance, and suggest the need for further investigation with a

clinical trial that will compare the long-term efficacy and

tolerability.

>

> > I was on minocycline but when it seemed to lose its

effectiveness,

> I switched to

> > doxcycline. You mention zithromax which I am not familiar with.

> Is this a new

> > drug for rosacea or one which has been around for awhile but is

> less known than

> > the tetracyclines? Do you take it every day and does it make you

> photosensitive?

>

> a, Zithromax (azithromycin) is another type of antibiotic, a

> variant of erythomycin. All antibiotics work by the same proposed

> anti-inflammatory mechanism. Its chief benefit is that it is easier

> to maintain a good blood level because it is taken only once a day

> and isn't inactivated by dairy products or antacids. It also does

not

> cause photosensitivity, and can be taken on an empty stomach. The

> downside is that it is quite expensive, far more so than even

> doxycycline, and has more potential side effects than does the

> tetracyclines (although it is still a relatively safe drug). The

> erythromycins as a group are less effective in most rosaceans than

> are the tetracycles/doxycyclines, but if doxycycline doesn't work

for

> you it is an option to discuss with your doctor, especially if it's

> inconvenient to take pills every 12 hours.

>

> Marjorie

>

> Marjorie Lazoff, MD

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Share on other sites

Guest guest

For rosacea 500 mg zithro loading with 250mg qd thereafter is miles

ahead of the others. But you should try minocyline first because

that may work indefinately for you. At least try 100 mg Minocin or

generic equivalent bid before graduating to Zithromax. Save

Zithromax for when minocyline stops working or if you can't use

Accutane.

Int J Dermatol 2000 Jan;39(1):45-50 Related Articles, Books, LinkOut

Azithromycin for the treatment of acne.

Fernandez-Obregon AC.

Hudson Dermatology & Skin Center, Hoboken, NJ 07030, USA.

BACKGROUND: Acne affects a large number of young adults, including

women, who often present with facial as well as truncal involvement.

Systemic antimicrobial agents currently used for the reduction of

inflammatory papules and cysts require frequent administration and

are sometimes associated with uncomfortable side-effects contributing

to a decrease in compliance. METHODS: Ninety-nine episodes of

inflammatory acne in 79 patients treated with oral antimicrobial

agents were studied retrospectively over a period of 46 weeks.

Patients were treated with tetracycline, erythromycin, minocycline,

and doxycycline, the most commonly prescribed oral antimicrobials

used to treat acne. Individuals that were unable to tolerate this

therapy or had failed conventional therapy were treated with the

azalide antibiotic azithromycin, given in a single oral 250-mg dose

three times a week. The other agents were administered daily in

divided doses as is current practice. Patients were also on topical

care. RESULTS: The efficacy and reported side-effects were examined

for all agents. Significant improvement was noted in 4 weeks. All

agents were effective in reducing inflammatory lesions and improving

acne. Azithromycin produced a slightly higher percentage of patients

with a greater than 80% reduction in their inflammatory acne lesions

(85.7%) vs. an average of 77.1% for all other agents. All differences

observed were not statistically significant. CONCLUSIONS: The results

show that azithromycin is a safe and effective alternative in the

treatment of inflammatory acne with few side-effects and good

compliance, and suggest the need for further investigation with a

clinical trial that will compare the long-term efficacy and

tolerability.

>

> > I was on minocycline but when it seemed to lose its

effectiveness,

> I switched to

> > doxcycline. You mention zithromax which I am not familiar with.

> Is this a new

> > drug for rosacea or one which has been around for awhile but is

> less known than

> > the tetracyclines? Do you take it every day and does it make you

> photosensitive?

>

> a, Zithromax (azithromycin) is another type of antibiotic, a

> variant of erythomycin. All antibiotics work by the same proposed

> anti-inflammatory mechanism. Its chief benefit is that it is easier

> to maintain a good blood level because it is taken only once a day

> and isn't inactivated by dairy products or antacids. It also does

not

> cause photosensitivity, and can be taken on an empty stomach. The

> downside is that it is quite expensive, far more so than even

> doxycycline, and has more potential side effects than does the

> tetracyclines (although it is still a relatively safe drug). The

> erythromycins as a group are less effective in most rosaceans than

> are the tetracycles/doxycyclines, but if doxycycline doesn't work

for

> you it is an option to discuss with your doctor, especially if it's

> inconvenient to take pills every 12 hours.

>

> Marjorie

>

> Marjorie Lazoff, MD

Link to comment
Share on other sites

Guest guest

For rosacea 500 mg zithro loading with 250mg qd thereafter is miles

ahead of the others. But you should try minocyline first because

that may work indefinately for you. At least try 100 mg Minocin or

generic equivalent bid before graduating to Zithromax. Save

Zithromax for when minocyline stops working or if you can't use

Accutane.

Int J Dermatol 2000 Jan;39(1):45-50 Related Articles, Books, LinkOut

Azithromycin for the treatment of acne.

Fernandez-Obregon AC.

Hudson Dermatology & Skin Center, Hoboken, NJ 07030, USA.

BACKGROUND: Acne affects a large number of young adults, including

women, who often present with facial as well as truncal involvement.

Systemic antimicrobial agents currently used for the reduction of

inflammatory papules and cysts require frequent administration and

are sometimes associated with uncomfortable side-effects contributing

to a decrease in compliance. METHODS: Ninety-nine episodes of

inflammatory acne in 79 patients treated with oral antimicrobial

agents were studied retrospectively over a period of 46 weeks.

Patients were treated with tetracycline, erythromycin, minocycline,

and doxycycline, the most commonly prescribed oral antimicrobials

used to treat acne. Individuals that were unable to tolerate this

therapy or had failed conventional therapy were treated with the

azalide antibiotic azithromycin, given in a single oral 250-mg dose

three times a week. The other agents were administered daily in

divided doses as is current practice. Patients were also on topical

care. RESULTS: The efficacy and reported side-effects were examined

for all agents. Significant improvement was noted in 4 weeks. All

agents were effective in reducing inflammatory lesions and improving

acne. Azithromycin produced a slightly higher percentage of patients

with a greater than 80% reduction in their inflammatory acne lesions

(85.7%) vs. an average of 77.1% for all other agents. All differences

observed were not statistically significant. CONCLUSIONS: The results

show that azithromycin is a safe and effective alternative in the

treatment of inflammatory acne with few side-effects and good

compliance, and suggest the need for further investigation with a

clinical trial that will compare the long-term efficacy and

tolerability.

>

> > I was on minocycline but when it seemed to lose its

effectiveness,

> I switched to

> > doxcycline. You mention zithromax which I am not familiar with.

> Is this a new

> > drug for rosacea or one which has been around for awhile but is

> less known than

> > the tetracyclines? Do you take it every day and does it make you

> photosensitive?

>

> a, Zithromax (azithromycin) is another type of antibiotic, a

> variant of erythomycin. All antibiotics work by the same proposed

> anti-inflammatory mechanism. Its chief benefit is that it is easier

> to maintain a good blood level because it is taken only once a day

> and isn't inactivated by dairy products or antacids. It also does

not

> cause photosensitivity, and can be taken on an empty stomach. The

> downside is that it is quite expensive, far more so than even

> doxycycline, and has more potential side effects than does the

> tetracyclines (although it is still a relatively safe drug). The

> erythromycins as a group are less effective in most rosaceans than

> are the tetracycles/doxycyclines, but if doxycycline doesn't work

for

> you it is an option to discuss with your doctor, especially if it's

> inconvenient to take pills every 12 hours.

>

> Marjorie

>

> Marjorie Lazoff, MD

Link to comment
Share on other sites

Guest guest

> Int J Dermatol 2000 Jan;39(1):45-50

>

>

> Azithromycin for the treatment of acne.

>

> Fernandez-Obregon AC.

>

> Hudson Dermatology & Skin Center, Hoboken, NJ 07030, USA.

007, this study is on acne, not rosacea -- two completely different

conditions in which antibiotics are suspected to work in two

different ways. Of course the two conditions can co-exist, but this

study still has nothing to do with rosacea. Second, the study wasn't

single-blinded much less double-blinded, placebo-controlled, multi-

centered or anything else we look for in a good study. By the

abstract it sounds like just an observational report, where Fernandez-

Obregon knew which patients were on which antibiotics at all times.

Typically, observational reports are funded by the drug company, for

obvious reasons. Third, the bottom line is that they didn't find

anything statistically significant. Fourth, the only good thing to

come out of Hoboken, NJ was Sinatra.

Seriously, that's not to say that azithromycin isn't helpful for some

people with rosacea. It's just that this study has nothing to say

about that, one way or the other.

Marjorie

Marjorie Lazoff, MD

Link to comment
Share on other sites

Guest guest

> Int J Dermatol 2000 Jan;39(1):45-50

>

>

> Azithromycin for the treatment of acne.

>

> Fernandez-Obregon AC.

>

> Hudson Dermatology & Skin Center, Hoboken, NJ 07030, USA.

007, this study is on acne, not rosacea -- two completely different

conditions in which antibiotics are suspected to work in two

different ways. Of course the two conditions can co-exist, but this

study still has nothing to do with rosacea. Second, the study wasn't

single-blinded much less double-blinded, placebo-controlled, multi-

centered or anything else we look for in a good study. By the

abstract it sounds like just an observational report, where Fernandez-

Obregon knew which patients were on which antibiotics at all times.

Typically, observational reports are funded by the drug company, for

obvious reasons. Third, the bottom line is that they didn't find

anything statistically significant. Fourth, the only good thing to

come out of Hoboken, NJ was Sinatra.

Seriously, that's not to say that azithromycin isn't helpful for some

people with rosacea. It's just that this study has nothing to say

about that, one way or the other.

Marjorie

Marjorie Lazoff, MD

Link to comment
Share on other sites

Guest guest

> Int J Dermatol 2000 Jan;39(1):45-50

>

>

> Azithromycin for the treatment of acne.

>

> Fernandez-Obregon AC.

>

> Hudson Dermatology & Skin Center, Hoboken, NJ 07030, USA.

007, this study is on acne, not rosacea -- two completely different

conditions in which antibiotics are suspected to work in two

different ways. Of course the two conditions can co-exist, but this

study still has nothing to do with rosacea. Second, the study wasn't

single-blinded much less double-blinded, placebo-controlled, multi-

centered or anything else we look for in a good study. By the

abstract it sounds like just an observational report, where Fernandez-

Obregon knew which patients were on which antibiotics at all times.

Typically, observational reports are funded by the drug company, for

obvious reasons. Third, the bottom line is that they didn't find

anything statistically significant. Fourth, the only good thing to

come out of Hoboken, NJ was Sinatra.

Seriously, that's not to say that azithromycin isn't helpful for some

people with rosacea. It's just that this study has nothing to say

about that, one way or the other.

Marjorie

Marjorie Lazoff, MD

Link to comment
Share on other sites

Guest guest

Well, it says what it says. It says that zithro is as safe as

tetracyline, etc. essentially. Moreover we need to extract the

following by logical reasoning.

1. They used a small dose of three 250 capsules per week, and this

was essentially better (+/- statistical significance) than minocyline

(200 mg/d), doxycyline (200 mg/d), eyrthromycin and tetracyline (both

1 g /d) -- this is in the text, etc.

2. The dose of minocyline of 200 mg/d generally produces great

improvement in inflammatory rosacea.

3. If you use a REAL dose of 500 mg loading and 250 mg qd there

after of zithromax, you will get a result much better than

conventional current run of the mill therapy. IN OTHER WORDS A LOW

DOSE OF ZITHRO IS AS EFFECTIVE AS FULL DOSE MINOCYLINE. IMAGINE WHAT

A REAL DOSE OF ZITHRO WOULD DO :) Another study was explained in Dr.

Nase's book in which it showed that a mere 250 mg bid clarithromycin

was superior to 100 doxycycline bid. Don't have the cite at the top

of my head. And I'm generally a fan of minocyline and previously

thought it was better than zithromax. Now I know, clinically, backed

by some research, that zithromax is better. Clinically, I would rate

biaxin as less than minocyline. So in order of descending efficacy

at full dosage: zithro, mino, clari, doxy, tetra, erythro.

Incidentally, zithro and mino have high skin levels, and the newer

macrolides cover for staph aureus, a common cause of papulopustular

eruptions resistant to tetracyline therapy.

4. Inflammatory rosacea is very similar in regards to oral

antibiotic therapy as acne therapy with oral antibiotics.

Parrallelisms can be drawn. Therefore, a really good rosacea

treatment, especially for inflammatory rosacea -- zithromax also

being incidentally also just as safe as the other antibiotics.

5. If you want a double blinded study, multicentered, you're simply

dreaming. This isn't going to happen anytime soon unless Bill Gates

creates a rosacea foundation! Or someone on this list wins one of

those pick the number lotteries. Anyone want to meet in Las

Vegas??? Off label use is often where the best treatments hide

gleaned for by deductive, logical reasoning.

6. Bottom line, if you want quick improvement, do the right

antibiotic at the right dose. If you couldn't care less about when

you'll improve, and if you enjoy a slow, methodical, tedious,

stepwise approach, use 500 mg/d tetracyline --- oh, and don't plan

any dates for a couple of months or any pressing social engagements

in which you want/need your skin to look exceptionally well at.

7. Sinatra is good, you're right.

>

> > Int J Dermatol 2000 Jan;39(1):45-50

> >

> >

> > Azithromycin for the treatment of acne.

> >

> > Fernandez-Obregon AC.

> >

> > Hudson Dermatology & Skin Center, Hoboken, NJ 07030, USA.

>

> 007, this study is on acne, not rosacea -- two completely different

> conditions in which antibiotics are suspected to work in two

> different ways. Of course the two conditions can co-exist, but this

> study still has nothing to do with rosacea. Second, the study

wasn't

> single-blinded much less double-blinded, placebo-controlled, multi-

> centered or anything else we look for in a good study. By the

> abstract it sounds like just an observational report, where

Fernandez-

> Obregon knew which patients were on which antibiotics at all times.

> Typically, observational reports are funded by the drug company,

for

> obvious reasons. Third, the bottom line is that they didn't find

> anything statistically significant. Fourth, the only good thing to

> come out of Hoboken, NJ was Sinatra.

>

> Seriously, that's not to say that azithromycin isn't helpful for

some

> people with rosacea. It's just that this study has nothing to say

> about that, one way or the other.

>

> Marjorie

>

> Marjorie Lazoff, MD

Link to comment
Share on other sites

Guest guest

Well, it says what it says. It says that zithro is as safe as

tetracyline, etc. essentially. Moreover we need to extract the

following by logical reasoning.

1. They used a small dose of three 250 capsules per week, and this

was essentially better (+/- statistical significance) than minocyline

(200 mg/d), doxycyline (200 mg/d), eyrthromycin and tetracyline (both

1 g /d) -- this is in the text, etc.

2. The dose of minocyline of 200 mg/d generally produces great

improvement in inflammatory rosacea.

3. If you use a REAL dose of 500 mg loading and 250 mg qd there

after of zithromax, you will get a result much better than

conventional current run of the mill therapy. IN OTHER WORDS A LOW

DOSE OF ZITHRO IS AS EFFECTIVE AS FULL DOSE MINOCYLINE. IMAGINE WHAT

A REAL DOSE OF ZITHRO WOULD DO :) Another study was explained in Dr.

Nase's book in which it showed that a mere 250 mg bid clarithromycin

was superior to 100 doxycycline bid. Don't have the cite at the top

of my head. And I'm generally a fan of minocyline and previously

thought it was better than zithromax. Now I know, clinically, backed

by some research, that zithromax is better. Clinically, I would rate

biaxin as less than minocyline. So in order of descending efficacy

at full dosage: zithro, mino, clari, doxy, tetra, erythro.

Incidentally, zithro and mino have high skin levels, and the newer

macrolides cover for staph aureus, a common cause of papulopustular

eruptions resistant to tetracyline therapy.

4. Inflammatory rosacea is very similar in regards to oral

antibiotic therapy as acne therapy with oral antibiotics.

Parrallelisms can be drawn. Therefore, a really good rosacea

treatment, especially for inflammatory rosacea -- zithromax also

being incidentally also just as safe as the other antibiotics.

5. If you want a double blinded study, multicentered, you're simply

dreaming. This isn't going to happen anytime soon unless Bill Gates

creates a rosacea foundation! Or someone on this list wins one of

those pick the number lotteries. Anyone want to meet in Las

Vegas??? Off label use is often where the best treatments hide

gleaned for by deductive, logical reasoning.

6. Bottom line, if you want quick improvement, do the right

antibiotic at the right dose. If you couldn't care less about when

you'll improve, and if you enjoy a slow, methodical, tedious,

stepwise approach, use 500 mg/d tetracyline --- oh, and don't plan

any dates for a couple of months or any pressing social engagements

in which you want/need your skin to look exceptionally well at.

7. Sinatra is good, you're right.

>

> > Int J Dermatol 2000 Jan;39(1):45-50

> >

> >

> > Azithromycin for the treatment of acne.

> >

> > Fernandez-Obregon AC.

> >

> > Hudson Dermatology & Skin Center, Hoboken, NJ 07030, USA.

>

> 007, this study is on acne, not rosacea -- two completely different

> conditions in which antibiotics are suspected to work in two

> different ways. Of course the two conditions can co-exist, but this

> study still has nothing to do with rosacea. Second, the study

wasn't

> single-blinded much less double-blinded, placebo-controlled, multi-

> centered or anything else we look for in a good study. By the

> abstract it sounds like just an observational report, where

Fernandez-

> Obregon knew which patients were on which antibiotics at all times.

> Typically, observational reports are funded by the drug company,

for

> obvious reasons. Third, the bottom line is that they didn't find

> anything statistically significant. Fourth, the only good thing to

> come out of Hoboken, NJ was Sinatra.

>

> Seriously, that's not to say that azithromycin isn't helpful for

some

> people with rosacea. It's just that this study has nothing to say

> about that, one way or the other.

>

> Marjorie

>

> Marjorie Lazoff, MD

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