Azithromycin Pulse Therapy with Oral Doxycycline in the Treatment of Acne Vulgaris, a Randomized Group Study

Acne vulgaris is a common dermatological problem. The choice of proper treatment is determined by the severity and extent of acne. Moderate to severe acne vulgaris cases respond well to systemic antibiotics. Antibiotics execute their anti-propionic bacterium effect by inhibiting the bacterial growth and colonization of pilosebaceous glands and thus further inflammation is prevented. The efficacy and possible side effects of various oral antibiotics has been the subject of numerous studies for at least the last twenty years in an effort to understand, which products are likely to produce better efficacy with least possible side effects. The new emerging problem is antibiotics resistance to propionic bacterium. There has been a constant increase in search of safe medications to overcome the side effects and resistance of existing formulations for the treatment of acne vulgaris. The study duration was 8 weeks. A total of 200 study participants of both sexes with complaints of acne vulgaris were included in the study and randomized into two groups. Group I (100 study subjects) – 500 mg Azithromycin once daily for three consecutive days in a week for 2 months and Group II (100 study subjects) –100 mg Doxycycline once daily for 2 months. After doing initial laboratory tests treatment was initiated. Three scheduled visits – Baseline, at the end 4th week and at the end of study were done and the response to treatment was evaluated. The efficacy of the drugs was assessed by the change in grading of acne from baseline and at follow up visits. Doxycycline was found to be better than azithromycin pulse therapy in reducing acne severity. During the visits gastrointestinal, dermatological and other side effects were also noted and recorded. Adverse event profile of both the drugs showed that there was no non- compliance incidence due to adverse event. But the number of adverse events was higher in doxycycline group.