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The CLEAR regimen (Concomitant Levofloxacin, Ethambutol, Azithromycin, and Rifampin) is a combination antibiotic therapy developed by Vanderbilt University for the treatment of sarcoidosis, particularly chronic cutaneous sarcoidosis. The rationale for this therapy is based on the hypothesis that sarcoidosis may be triggered by a persistent immune response to mycobacterial antigens. By combining four anti-mycobacterial agents, the regimen aims to eradicate potential pathogenic triggers and induce the resolution of granulomatous lesions. Azithromycin, a key component of the regimen, is a macrolide antibiotic that inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit. The regimen has been evaluated in Phase I/II clinical trials to assess its safety and efficacy in resolving cutaneous sarcoidosis lesions.
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