Gloor M, Pfahler E, Neumann W, Höffler U, Hoffmann M, Schmidt U
Z Hautkr. 1982 Jun 15;57(12):867-78.
16 healthy persons were treated for 7 weeks with a 1% erythromycin containing ointment. Another 25 persons (among them 10 acne patients) were treated during the same period of time with a combination therapy consisting of erythromycin (1% in an unspecific ointment base) and benzoylperoxide (5% in a gel base). The combined therapy reduces the micrococcaceae in the pilosebaceous ducts significantly. On the other side the therapy consisting only of erythromycin causes only initially a decrease and then an increase in the number of micrococcaceae. Induction of resistance to erythromycin is in both cases considerable. In both cases a reduction of propionibacteria which are most important for the pathogenesis of acne must be assumed. Because of the probable pathogenetic role of staphylococci in acne vulgaris an additional improvement of the therapeutical results can be expected in the case of combination therapy. In vitro experiments demonstrate further that an erythromycin treatment leads to considerable resistance induction in S. aureus, regardless of whether it is applied alone or in combination with benzoyl peroxide.