Treatment of acne vulgaris without antibiotics: tertiary amine–benzoyl peroxide combination vs. benzoyl peroxide alone (Proactiv Solution™)

Authors

  • Craig G. Burkhart MPH, MD,

    1. From the Medical University of Ohio at Toledo and Ohio University School of Osteopathic Medicine, Sylvania, Ohio, and Department of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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  • Craig N. Burkhart MSBS, MD

    1. From the Medical University of Ohio at Toledo and Ohio University School of Osteopathic Medicine, Sylvania, Ohio, and Department of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Craig G. Burkhart, MPH, md Medical University of Ohio at Toledo5600 Monroe StreetSuite 106BSylvania, Ohio
E-mail: cgbakb@aol.com

Abstract

Background  Concerns have arisen over the development of antibiotic-resistant organisms due to the prolonged use of oral and topical antibiotics in acne vulgaris. We have previously demonstrated that benzoyl peroxide used in consort with a chemical with an accessible tertiary amine, such as an allylamine, increases radical activity and biological effect.

Objectives  The purpose of this pilot study was to assess the efficacy of two nonantibiotic topical remedies for mild to moderate acne, with one of the agents being a combination of benzoyl peroxide with butenifine, an allylamine.

Methods  In an open-label, patient-satisfaction, 8-week comparative study, 23 patients demonstrating mild to moderate facial acne were given randomly either benzoyl peroxide in Proactiv Solution or the combination of benzoyl peroxide with an allylamine.

Results  The allylamine–benzoyl peroxide combination therapy outperformed Proactiv Solution during each 2-week stage of evaluation in terms of reduction of comedones, inflammatory lesions, and degree of oiliness. There was a marked preference for the allylamine–benzoyl peroxide combination in terms of patient satisfaction.

Conclusions  Benzoyl peroxide used in consort with antimicrobial agents that contain an accessible tertiary amine, such as erythromycin, has previously been shown to increase radical activity and biological effect. Trials of short duration with small numbers of patients do not adequately inform practitioners about whether the combination of allylamines with benzoyl peroxide is a viable alternative to topical antibiotic therapy for acne. Nevertheless, the higher satisfaction with the allylamine–benzoyl peroxide combination certainly warrants further investigation.

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