What is a topically applied antibiotic thought to work through anti-inflammatory effects to treat rosacea?

Metronidazole is a topically applied medication that is effective in treating rosacea primarily because of its anti-inflammatory properties rather than its antibiotic action alone. While metronidazole does possess antimicrobial activity, it is its ability to reduce inflammatory lesions and the associated erythema in rosacea that makes it particularly beneficial for patients suffering from this condition. The mechanism by which metronidazole exerts its effect in rosacea may involve the suppression of inflammatory mediators, making the skin less red and irritated.

In contrast, other treatments mentioned, although having their own applications, do not address the specific inflammatory component of rosacea as effectively. For example, brimonidine is also used for the management of facial erythema in rosacea, but it works primarily as a selective alpha-2 adrenergic agonist, not through anti-inflammatory effects. Doxycycline, while it has anti-inflammatory effects and is used for treating rosacea, is typically administered orally rather than topically. Benzoyl peroxide is mainly an acne treatment with antibacterial and exfoliating properties, but it is not commonly used for rosacea and is not particularly focused on anti-inflammatory effects.

Thus, metronidazole stands out as the most appropriate choice for its targeted