Comparison of oral azithromycin pulse with daily doxycycline in the treatment of acne vulgaris.

Oral azithromycin has been advocated by some in the treatment of acne. However, its efficacy has not been established.This non-randomized controlled trial was conducted on 70 outpatients with acne vulgaris to compare the efficacy and safety of azithromycin and doxycycline in the treatment of inflammatory acne. In the first group, azithromycin was administered 500 mg daily before meals for 3 consecutive days in a 10-day cycle, with the remaining seven days in each cycle being drug-free days. The second group was given doxycycline 100 mg daily after meals. Topical erythromycin was prescribed to all patients. Clinical assessment was done at 10-day intervals for both the groups up to three months. We followed the severity index described by Michaelsson for assessment of outcome measures.There was 77.26% improvement in azithromycin treated group in comparison to 63.74% in the doxycycline treated group. There was a statistically significant reduction in severity in the azithromycin treated group.The study showed that a combination of azithromycin with topical erythromycin was significantly better than doxycycline with topical erythromycin in the treatment of acne vulgaris. The incidence and severity of side effects were also lower with azithromycin.