Randomized comparative study of combination of low dose oral isotretinoin with pulsed azithromycin and low dose oral isotretinoin alone in the management of moderate to severe acne

Rashmi Jindal; Samarjit Roy; Akanksha Jain

doi:10.18203/issn.2455-4529.IntJResDermatol20180141

Authors

Rashmi Jindal Department of Dermatology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand
Samarjit Roy Department of Dermatology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand
Akanksha Jain Department of Dermatology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20180141

Keywords:

Isotretinoin, Azithromycin, Acne

Abstract

Background: Oral isotretinoin and azithromycin are two important drugs used in management of acne. Their mode of action is different and thus theoretically the combination of these two should have a synergistic effect.

Methods: In this randomized comparative trial 100 patients were randomized into two groups. One received oral isotretinoin (0.3 mg/kg/day) alone and the other group received pulsed azithromycin (500 mg/day for three days in a week for 8 weeks) in addition to oral isotretinoin. Improvement in acne was noted as percentage improvement in mean acne score.

Results: No statistically significant difference was noted in the improvement in mean acne score of both the groups.

Conclusions: Addition of pulsed azithromycin to low dose oral isotretinoin does not offer a better treatment outcome in patients of moderate to severe acne.

Metrics

Metrics Loading ...

References

Bhate K, Williams HC. Epidemiology of acne vulgaris. Br J Dermatol. 2013;168:474-85.

Aenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74:945-73.

Doshi A, Zaheer A, Stiller MJ. A comparison of current acne grading systems and proposal of a novel system. Int J Dermatol. 1997;36:416-8.

Akman A, Durusoy C, Senturk M, Koc CK, Soyturk D, Alpossy E. Treatment of acne with intermittent and conventional isotretinoin: A randomised controlled multicenter study. Arch Dermatol Res. 2007;299:467-73.

Culniffe WJ, van de Kerkhof PC, Caputo R, Cavicchini S, Cooper A, Fyrand OL, et al. Roaccutane treatment guidelines: results of an international survey. Dermatology. 1997;194:351-7.

Peck GL, Olsen TG, Yoder FW, Downing DT, Pandya M, et al. Prolonged remissions of cystic and conglobate acne with 13-cis-retinoic acid. N Engl J Med. 1979;300:329-33.

Farrell LN, Strauss JS, Stranieri AM. The treatment of severe cystic acne with 13-cis-retinoic acid. Evaluation of sebum production and the clinical response in a multiple-dose trial. J Am Acad Dermatol. 1980;3:602-11.

Goulden V, Clark SM, Cunliffe WJ. Post adolescent acne: A review of clinical features. Br J Dermatol. 1997;136:66-70.

Hermes B, Praetel C, Henz BM. Medium dose isotretinoin for the treatment of acne. J Eur Acad Dermatol Venereol. 1998;11:117-21.

Geissler SE, Michelsen S, Plewig G. Very low dose isotretinoin is effective in controlling seborrhoea. J Dtsch Dermatol Ges. 2003;1:952-8.

Amichai B. Long term mini doses of isotretinoin in the treatment of relapsing acne. J Dermatol. 2003;30:572.

Sardana K, Garg VK, Sehgal VN, Mahajan S, Bhushan P. Efficacy of fixed low-dose isotretinoin (20 mg, alternate days) with topical clindamycin gel in moderately severe acne vulgaris. J Eur Acad Dermatol Venereol. 2009;23:556-60.

Jones DH, King K, Miller AJ, Cunliffe WJ. A dose-response study of I3-cis-retinoic acid in acne vulgaris. Br J Dermatol. 1983;108:333-43.

De D, Kanwar AJ. Combination of Low-Dose Isotretinoin and Pulsed Oral Azithromycin in the Management of Moderate to Severe Acne. A Preliminary Open-Label, Prospective, Non-Comparative, Single-Centre Study. Clin Drug Investig. 2011;31:599-604.

Hasibur MR, Meraj Z. Combination of low-dose isotretinoin and pulsed oral azithromycin for maximizing efficacy of acne treatment. Mymensingh Med J. 2013;22:42-8.