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April 25, 1966

Antibiotics and the Placebo Reaction in Acne

JAMA. 1966;196(4):365-367. doi:10.1001/jama.1966.03100170107040

TETRACYCLINE has been widely accepted as a highly effective and reliable agent in the treatment of acne vulgaris. Its effectiveness is attested to by the clinical experience of numerous dermatologists, but is not supported by the majority of double-blind studies. Two well-controlled clinical studies demonstrated that tetracycline was clearly more effective than a placebo, and two similarly controlled studies showed no significant difference.1-4

For editorial comment, see page 362.

The pharmacological effectiveness of tetracycline was questioned for several reasons. First, the dose used in acne therapy is relatively low. Secondly, tetracycline might be expected to induce a high rate of placebo benefit because it is a modern wonder drug, it is expensive, and ideally it might free the patient from the drudgery of constant topical care.

In order to determine the effectiveness of antibiotics in the treatment of acne and to delineate the percentage of placebo reactors, we undertook

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