Stimulated by our recent finding that topical benzoyl peroxide therapy lowers fatty acids more effectively than systemic tetracycline therapy, we have reevaluated the roll of topical antibacterial therapy for acne. A rapid screening of many compounds was made possible by utilizing infrared spectroscopy to determine the fatty acid to fatty ester ratio (FA/FE ratio) in sebum. Several members of the family of erythromycins were as effective as benzoyl peroxide in reducing the FA/FE ratio in sebum. Erythromycin (2%) therapy was quite effective in reducing the inflammatory lesions in ten acne patients, although the reduction in comedones was not as drastic. The combination of these antibacterials with follicular irritants such as tretinoin should be quite a useful adjunct to acne therapeutics.
Fulton JE. Topical Antibacterial Therapy for AcneStudy of the Family of Erythromycins. Arch Dermatol. 1974;110(1):83-86. doi:10.1001/archderm.1974.01630070051011