What do systematic reviews say?

Metronidazole vs placebo

Metronidazole probably leads to higher physician‐assessed improvement in rosacea severity compared with placebo (moderate certainty).

• Interventions for rosacea 2015 · Cochrane Headline outcomes only
  RR 1.98 [1.29, 3.02]
  3 studies · 334 participants
  Moderate

Topical metronidazole vs oral (oxy)tetracycline

• Interventions for rosacea 2015 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 81 participants
  Moderate

Doxycycline 40 mg + metronidazole 1% gel vs doxycycline 100 mg + metronidazole 1% gel

• Interventions for rosacea 2015 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 91 participants
  Low

Azelaic acid vs topical metronidazole

• Interventions for rosacea 2015 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 491 participants
  Low

Topical ivermectin vs topical metronidazole

Topical ivermectin leads to higher physician‐assessed improvement in rosacea severity compared with topical metronidazole (high certainty).

• Interventions for rosacea 2015 · Cochrane Headline outcomes only
  RR 1.13 [1.06, 1.2]
  1 study · 962 participants
  High

Doxycycline 40 mg + azelaic acid gel vs doxycycline 40 mg + metronidazole gel

Doxycycline 40 mg + azelaic acid gel showed no clear difference in physician‐assessed improvement in rosacea severity Investigator's… compared with doxycycline 40 mg + metronidazole gel (high certainty).

• Interventions for rosacea 2015 · Cochrane Headline outcomes only
  RR 1.08 [0.93, 1.27]
  1 study · 207 participants
  High