Topical antibiotic + BPO (acne) Pregnancy: No adequate data in pregnant women and safety in human pregnancy not established; only prescribe to pregnant women after careful risk/benefit assessment. Breast-feeding: not studied; percutaneous absorption is low but excretion in milk unknown — use only if the expected benefit justifies the potential risk, and do not apply to the breast area.

Benzoyl peroxide with clindamycin

Brand names: Duac, Acnecide

This fixed-combination topical gel pairs benzoyl peroxide with the antibiotic clindamycin for mild-to-moderate inflammatory acne.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Apply as a thin film to the entire affected area

Route: Topical (cutaneous use only)

Frequency: Once daily in the evening

Adults and adolescents aged 12 years and above. Apply after washing gently with a mild cleanser and drying fully; if the gel does not rub into the skin easily, too much is being applied. Wash hands after application. Excessive application will not improve efficacy but may increase the risk of skin irritation. If excessive dryness or peeling occurs, reduce the frequency of application or temporarily interrupt treatment (efficacy has not been established for less than once daily dosing). Safety and efficacy have not been studied beyond 12 weeks in acne vulgaris clinical trials — treatment should not exceed 12 weeks of continuous use. Paediatric: safety and efficacy not established in children under 12 years, so not recommended in this population. Elderly: no specific recommendations. Discontinue immediately if prolonged or significant diarrhoea or abdominal cramps occur (possible antibiotic-associated colitis). Source SPC is for Clindamycin + Benzoyl Peroxide 10 mg/g + 30 mg/g Gel.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Known hypersensitivity to clindamycin
Known hypersensitivity to lincomycin
Known hypersensitivity to benzoyl peroxide
Known hypersensitivity to any of the excipients

Side effects

Pruritus, burning sensation, dryness, erythema, peeling (generally slight)
Dermatitis, photosensitivity reaction
Colitis (including pseudomembranous colitis), haemorrhagic diarrhoea, diarrhoea, abdominal pain
Headache, paraesthesia; application site pain and application site reactions including skin discoloration
Allergic reactions including hypersensitivity and anaphylaxis; erythematous rash, worsening of acne, urticaria

Interactions

No formal drug-drug interaction studies have been performed with this combination gel
Concomitant topical antibiotics, medicated or abrasive soaps and cleansers, and soaps/cosmetics with a strong drying effect — caution (cumulative irritancy)
Cross-resistance may occur with other antibiotics such as lincomycin and erythromycin when antibiotic monotherapy is used

Clinical monograph

How it works

Clindamycin inhibits bacterial protein synthesis against Cutibacterium acnes while benzoyl peroxide provides complementary bactericidal and keratolytic action and limits emergence of antibiotic resistance.

Prescribing in practice

Combining the antibiotic with benzoyl peroxide reduces the risk of antibiotic resistance, and topical antibiotics should not be used as monotherapy or for prolonged courses.
Benzoyl peroxide bleaches hair and dyed fabrics, so warn patients about contact with clothing and bedding.
Local irritation, dryness and peeling are common; avoid the eyes, lips and mucous membranes.

Monitoring

No laboratory monitoring is required; review skin tolerability and acne response, and limit the duration of antibiotic use.

Counselling the patient

Apply to clean, dry skin as directed and avoid the eyes and mouth.
It may bleach coloured fabrics, towels, bedding and hair.
Use for the recommended period only and use sun protection as skin may be more sun-sensitive.

Evidence & guidelines

NICE recommends fixed combinations of a topical antibiotic with benzoyl peroxide for acne, advising against topical antibiotic monotherapy to limit resistance.

Reference: NICE NG198; BAD; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways