COMPARISON OF ORAL AZITHROMYCIN WITH ORAL DOXYCYCLINE IN THE TREATMENT OF ACNE VULGARIS
AbstractBackground: Acne vulgaris is a common inflammatory disorder of the skin that involves pilosebaceous units. This study was conducted to compare the efficacy of oral azithromycin with oral doxycycline in the treatment of acne vulgaris in our population. Methods: This randomized controlled trial was conducted in the dermatology department of Lady Reading Hospital, Peshawar from January to December 2011. All male and female patients of age (14–30 years) having moderate acne vulgaris on face only were included in the study. Patients were randomly divided into two groups. Patients in first group were given azithromycin 500 mg daily before meal for 4 consecutive days monthly for 3 months while patients in second group were given doxycycline 100 mg daily after meals for 3 months. Patients were followed up after taking treatment for three months to see the response of each drug. Response was graded as excellent, good, moderate, mild and no response. Results: A total of 386 patients equally divided in azithromycin and doxycycline groups. Male to female ratio in azithromycin and doxycycline groups was 0.82:1.11 and 0.89:1.04 respectively. Mean age in both groups was 18.45±2.91 years and 17.96±2.59 years respectively. In azithromycin group, an excellent response was noted in 6 (3.1%), and good response was observed in 44 (22.8%) patients. In doxycycline group 22 (11.4%) patients had excellent and 107 (55.4%) patients had good response. The difference being statistically significant. Conclusion: Doxycycline is a better option for treatment of acne vulgaris as compared to azithromycin.Keywords: Doxycycline, Azithromycin, Acne vulgaris
Kus S, Yucelten D, Aytug A. Comparison of efficacy of azithromycin vs doxycycline in the treatment of acne vulgaris. Clin Exp Dermatol 2005;30:215–20.
Amin K, Riddle CC, Aries DJ, Schweiger ES. Common and alternate oral antibiotic therapies for acne vulgaris. J Drugs Dermatol 2007;6:873–80.
Norris JF, Cunliffe WJ. A histological and immunocytochemical study of early acne lesions. . Br J Dermatol 1988;118:651–9.
Singhi MK, Ghiya BC, Dhabhai RK. Comparison of oral azithromycin pulse with daily doxycycline in the treatment of acne vulgaris. Indian J Dermatol Venereol Leprol 2003;69:274–6.
Fernandez-obregon AC. Azithromycin for the treatment of acne. Int J Dermatol 2000;39:45–50.
Peter DH, Friedel HA, McTavish D. Azithromycin. A review of its antimicrobial activity, pharmacokinetics properties and its clinical efficacy. Drug 1992;44:750–99.
Alvreg-Elroco S, Enzler MJ. The macrolides. Erythromycin, clarithromycin and azithromycin. Mayo Clinic Proc 1999;74:613–34.
Lalak NJ, Moris DL. Azithromycin clinical pharmacokinetics. Clin Pharmacokinet 1993;25:370–4.
Gruber F, Grubisic-Greblo H, Kastelan M, Brajac I, Lenković M, Zamolo G. Azithromycin compared with minocycline in the treatment of acne comedonica and papulo-pustulosa. J Chemother 1998;10:469–73.
Pochi PE. The pathogenesis and treatment of acne. Annu Rev Med 1990;41:187–98.
Parsad D, Pandhi R, Nagpal R, Negi KS. Azithromycin monthly pulse vs. daily doxycycline in the treatment of acne vulgaris. J Dermatol 2001;28(1):1–4
Layton AM. Optimal management of acne to prevent scarring and psychological sequelae. Am J Clin Dermatol 2001;2(3):135–41
Cunliffe WG, Simpson NB. Disorders of the sebaceous glands. In: Champion RH, Burton JL, Burns DA, Breathnack SM, Editors. Textbook of dermatology. Vol-2. 6th ed. Oxford: Blackwell Science; 1998.p. 1927–1984
Eady EA, Cove JH, Holland KT, Cunliffe WJ. Erythromycin resistant Propionibacteria in antibiotic- treated acne patients: association with therapeutic failure. Br J Dermatol 1989;121:51–7
Oncu S, Punar M, Eraksoy H. Comparative activities of beta-lactam antibiotics and quinolones for invasive Streptococcus pneumoniae isolates. Chemotherapy 2004;50:98–100
Jacobs MR, Bajaksouzian S, Windau A, Good CE, Lin G, Pankuch GA, et al. Susceptibility of Streptococcus pneumoniae, Haemophilus influenza, and Moraxella catarrhalis to 17 oral antimicrobial agents based on pharmacodynamic parameters: 1998–2001 US Surveillance Study. Clin Lab Med 2004;24:503–30.
Naieni FF, Akrami H. Comparison of three different regimens of oral azithromycin in the treatment of acne vulgaris. Indian J Dermatol 2006;51:255–7.