Comparative study of two different regimens of oral azithromycin in the treatment of acne vulgaris

Abstract
Background: Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous units. Oral antibiotics are the most widely administered drugs. Azithromycin is one of the antibiotics that has been recently prescribed for acne treatment. There are several protocols of oral azithromycin in the treatment of acne vulgaris.

Objective: The purpose of the present study was to compare two regimens of oral azithromycin in the treatment of acne vulgaris.

Methodology: This randomized open clinical trial was carried out for six (06) months. Total sixty patients with moderate to severe acne were randomly enrolled into two equal groups (group A and B). Group-A received oral azithromycin 250 mg daily for three consecutive days, weekly for 12 weeks. Group-B has been treated with oral azithromycin 500 mg daily on the first day and 250 mg for further two consecutive days weekly for 12 weeks. After the baseline visit patients were assessed 4th week, 8th week, and 12th week. They were assessed for symptom severity, number of comedones, papule, pustule, side effects, and treatment response.
Result: There were no differences between the two groups in decreasing of acne grading score. (P> 0.05). The efficacy of a minimal dose was equal to a maximum dose of azithromycin in the treatment of acne. Oral azithromycin in both groups resulted in a significant decrease in acne grading score in each consecutive visit (P<0.001).
Conclusion: Azithromycin in low dose 3000 mg monthly as effective as high dose 4000 mg with lower cost, more compliance, and fewer side-effects.
Keyword: Azithromycin, Acne Vulgaris.