Quality of evidence: I

We found no good evidence evaluating tetracycline versus placebo. Our search found one published RCT that evaluated the efficacy of tetracycline, 250 mg twice daily, compared with 1% metronidazole cream in the treatment of perioral dermatitis.3 In this study, oral tetracyline was found to be significantly more effective than metronidazole cream with 8 weeks of treatment (P<0-01). After 4 weeks, the number of papules in the tetracyline group was 4% of the original number, compared with 33% in the metronidazole group. At 8 weeks these numbers were 0% and 4%, respectively.

We also found some case series reporting the efficacy of oral tetracycline.6-10 Follow up periods for many of the case series ranged from 3 months to 2 years. Tetracycline was found to be effective, but relapse was common after discontinuation of treatment.6-10

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