title: Metronidazole in the treatment of rosacea: do formulation, dosing, and concentration matter?
abstract: BACKGROUND
  Topical metronidazole is commonly used in the management of rosacea. No consensus on the optimal formulation, concentration, or dosing regimen exists.
  
  
  OBJECTIVE
  To assess the relative efficacy of metronidazole cream, gel, and lotion at concentrations of 0.75% and 1%, in dosing regimens of once and twice daily.
  
  
  METHODS
  A meta-analysis of published metronidazole efficacy rates was performed.
  
  
  RESULTS
  In non-weighted analysis, the mean efficacy was 28.2% (95% confidence interval [CI], 22.0%-34.4%) for the cream, 38.4% (95% CI, 18.4%-58.4%) for the gel, and 35% for the lotion. Confidence intervals for QD versus BID dosing and 0.75% versus 1% concentrations also overlapped. In weighted analysis, the mean reduction was 31.3% for the cream, 22.1% for the gel, and 35% for the lotion.
  
  
  CONCLUSIONS
  Metronidazole cream, gel, and lotion vehicles have similar efficacies. There were no substantial differences between concentrations of 0.75% and 1%, or between once daily and twice daily regimens.
authors: Clinical Unit for Research Trials in Skin, Harvard Medical School, Boston, MA 02114, USA.
authors: Jane
authors: J
authors: Yoo
authors: David C
authors: DC
authors: Reid
authors: Alexa B
authors: AB
authors: Kimball