A MedCite article from June this year:
Title: A comparison of topical azelaic acid 20% cream and topical
metronidazole 0.75% cream in the treatment of patients with
papulopustular rosacea.
Journal: J Am Acad Dermatol
Author(s): Maddin S
Article Heading: J Am Acad Dermatol 40:6 Pt 1 961-5, 1999 Jun
Abstract:
BACKGROUND: Although it is important for physicians to have sufficient
clinical data on which to base treatment decisions, little comparative
data exist regarding newer treatment modalities for rosacea.
OBJECTIVE: The goal of the study was to compare the efficacy and safety
of topical azelaic acid 20% cream and topical metronidazole 0.75% cream
in the treatment of patients with papulopustular rosacea. Parameters of
patient satisfaction to treatment were also assessed.
METHODS: Forty patients with the clinical manifestation of symmetric
facial rosacea were investigated in this single-center, double-blind,
randomized, contralateral split-face comparison clinical trial.
RESULTS: After 15 weeks of treatment, both azelaic acid and
metronidazole induced significant, albeit equal reductions in the
number of inflammatory lesions (pustules and papules). A significantly
higher physician rating of global improvement was achieved with azelaic
acid. Changes in the rosacea signs and symptoms of dryness, burning,
telangiectasia, and itching were equal between treatments. A
reduction in erythema tended toward significance with azelaic acid at
week 15. A trace amount of stinging on application was noted with
azelaic acid; however, such discomfort did not appear to concern
patients because their overall impression of azelaic acid was superior
to that of metronidazole.
CONCLUSION: Azelaic acid 20% cream provides an effective and safe
alternative to metronidazole 0.75% cream with the added benefit of
increased patient satisfaction.