What do systematic reviews say?

Metronidazole vs placebo

Metronidazole showed no clear difference in proportion of participants with adverse event compared with placebo (high certainty).

• Interventions for rosacea 2015 · Cochrane Headline outcomes only
  RR 1.19 [0.94, 1.51]
  6 studies · 1773 participants
  High

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

Doxycycline 40 mg + metronidazole 1% gel may leads to lower proportion of participants with adverse event compared with doxycycline 100 mg + metronidazole 1% gel (low certainty).

• Interventions for rosacea 2015 · Cochrane Headline outcomes only
  RR 0.25 [0.11, 0.54]
  1 study · 91 participants
  Low

Topical metronidazole vs oral (oxy)tetracycline

• Interventions for rosacea 2015 · Cochrane Headline outcomes only
  no estimate extracted
  4 studies · 258 participants
  Moderate

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 showed no clear difference in proportion of participants with adverse event compared with topical metronidazole (moderate certainty).

• Interventions for rosacea 2015 · Cochrane Headline outcomes only
  RR 2.28 [0.71, 7.35]
  1 study · 962 participants
  Moderate

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

Doxycycline 40 mg + azelaic acid gel showed no clear difference in proportion of participants with adverse event compared with doxycycline 40 mg + metronidazole gel (high certainty).

• Interventions for rosacea 2015 · Cochrane Headline outcomes only
  RR 0.27 [0.06, 1.28]
  1 study · 207 participants
  High