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A comparison of metronidazole 1% cream and pimecrolimus 1% cream in the treatment of patients with papulopustular rosacea: a randomized open-label clinical trial


  • Conflict of interest: none declared.

Dr Rafet Koca, Zonguldak Karaelmas Üniversitesi Tıp Fakültesi Dermatoloji Anabilim Dalı, Kozlu 67600, Zonguldak, Turkey


Background.  There are various treatment options available for rosacea, depending on the subtype, but treatment is still generally unsatisfactory. Some reports have indicated beneficial effects of topical pimecrolimus.

Aim.  To compare the efficacy and safety of pimecrolimus 1% cream and metronidazole 1% cream in the treatment of patients with papulopustular rosacea (PR).

Methods.  A group of 49 patients with PR was investigated in this single-centre, randomized, open-label study. Patients were randomly assigned treatment with either pimecrolimus 1% cream or metronidazole 1% cream for 12 weeks. Response was evaluated by the inflammatory lesion count, the severity of facial erythema and telangiectasia, Physician’s Global Assessment (PGA), and safety and tolerability at baseline and at weeks 3, 6, 9 and 12.

Results.  In total, 48 patients completed the study. Both treatments were very effective in the treatment of PR. There were no significant differences between the treatments in inflammatory lesion counts, overall erythema severity scores and PGA evaluated from baseline to week 12 (> 0.05). Neither treatment produced any clinically relevant improvement in telangiectasia.

Conclusion.  Pimecrolimus cream is no more efficacious than metronidazole cream in the treatment of PR.