A Comparative Study of Azithromycin Pulse Therapy with Minocycline in Acne Vulgaris

Background: Acne vulgaris is a common dermatological problem. Acne is most commonly found in adolescents, caused by increased androgens in both sexes. It is usually caused due to Propionibacterium acnes. Minocycline is a newly introduced drug in treating acne vulgaris. On the other hand, it is assumed that azithromycin having a long half-life like can be very effective with better compliance in treating acne vulgaris. But we have not enough research-based comparative data regarding this issue. Objective: The objective of this study was to compare the efficacy and safety of azithromycin pulse therapy with minocycline in treating acne vulgaris. Methods: This was a prospective, comparative study and was conducted in Department of Dermatology, Naogaon Medical College, Naogaon, Bangladesh, during the period from January 2021 to December 2021. In total 80 patients with moderate-to-moderately severe (Grade II and III), acne vulgaris were included in the study population. Patients were randomly assigned to two treatment groups of group A & group B respectively. In group A, there were 25 patients received 500 mg azithromycin once a day for 3 days per week as pulse therapy along with 0.05% topical tretinoin for 3 months whereas in group B, there were another 25 patients received 50 mg minocycline twice a day along with 0.05% topical tretinoin for 3 months. All data were processed, analyzed, and disseminated by SPSS version 23.0 and MS Office program. Results: In this study, group A (Azithromycin) between baseline and final score distribution we found a significant correlation (P=0.023). On the other hand, in group B we did not find any significant correlation (P=0.073). In analyzing the changes in severity score of acne from baseline to the final assessment of both groups we observed, in group A at baseline 15%, 38%, and 48% of participants had the score points 2, 3, and 4 respectively whereas in the final stage 63%, 30%, and 8% participants had the score point 1, 2 and 3 respectively. So, in group A between baseline and final score distribution, we found a significant correlation (P=0.023). On the other hand, in group B at baseline 10%, 40%, and 50% of participants had the scored points 2, 3, and 4 respectively whereas in the final stage 65%, 28%, and 8% of participants had the score point 1, 2 and 3 respectively. In group B between baseline and final score distribution we found P value 0.073. Conclusion: In this study, the efficacy of both azithromycin pulse therapy and minocycline was found satisfactory. But as per the findings regarding the safety profiles, we can conclude that minocycline is safer than azithromycin pulse therapy in treating acne vulgaris.