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AAF vs MC and MG

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Azelaic Acid 15% Foam (AAF) vs Metronidazole Cream (MC) and Metronidazole Gel (MG)

"MG- and MC-treated patients more frequently reported treatment concerns and side effects than AAF-treated patients, and tolerability of those side effects was higher for patients treated with AAF. While treatment cost is a more frequent concern in patients treated with AAF, these patients less frequently reported concerns with treatment efficacy and reported similar or greater tolerance to side effects than patients treated with either MC or MG."

J Drugs Dermatol. 2020 Mar 01;19(3):295-304
Rosacea Treatment Satisfaction: Matching Adjusted Indirect Treatment Comparison Analysis of Metronidazole Gel or Cream vs Azelaic Acid Foam.
Williamson T, LaRose A, Cameron J, Lott J, Eaddy M, Hopson S, Shih HC, Tennant LT

So according to the above paper you probably should consider AAF over MC/MG and refer this paper to your dermatologist who is prescribing metronidazole instead of azelaic acid

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