Evaluating Azithromycin Pulse Therapy and Minocycline: A Comparative Analysis for Acne Vulgaris Management

Abstract

Introduction: Acne vulgaris is a prevalent chronic inflammatory skin condition primarily affecting adolescents and young adults. Effective management strategies encompass a range of topical and systemic therapies, with antibiotics traditionally playing a vital role due to their antimicrobial and anti-inflammatory effects. This comparative study evaluates azithromycin pulse therapy against minocycline in treating acne vulgaris.

Methods and materials: A randomized controlled trial (RCT) was conducted in the Department of Dermatology & Venereology, Shaheed Ziaur Rahman Medical College and Hospital, Bogura, Bangladesh, from July 2022 to July 2023. A total of 200 Participants were randomly assigned to one of two treatment groups: azithromycin pulse therapy or daily minocycline therapy. Data was collected at baseline, at the end of treatment (week 4), and during a follow-up visit (week 8). Comparative analyses between treatment groups were performed using ANOVA for continuous variables and chi-square tests for categorical variables. A p-value of less than 0.05 was considered statistically significant.

Results: In this comparative study of azithromycin and minocycline for treating acne, the azithromycin group reported higher improvement rates, with 40% feeling "Much improved" versus 35% in the minocycline group—a statistically significant difference (p=0.01). Gastrointestinal side effects were more common in the azithromycin group (15%) compared to minocycline (10%), whereas skin reactions and photosensitivity were higher in the minocycline group. Antibiotic resistance slightly increased post-treatment in both groups, from 25% to 30% in the azithromycin group and from 20% to 25% in the minocycline group, indicating a greater increase in resistance among azithromycin-treated patients.

Conclusion: Azithromycin pulse therapy offers a favourable alternative with good compliance and a lower risk of resistance, ideal for those prioritizing ease and minimal side effects. Minocycline is effective but necessitates caution due to potential skin reactions. Treatment choice should consider individual profiles for optimal efficacy and satisfaction.