Comparison of efficacy of oral azithromycin with oral minocycline in the treatment of acne vulgaris

Background: Acne vulgaris is a common skin disease seen primarily in adolescents and young adults. As the treatment involves long-term therapy with antibiotics, an agent with a long half-life can be very useful in increasing the compliance. Objectives: The objective of this study was to evaluate the efficacy of a pulse dose of azithromycin and compare it with daily dose of minocycline in the treatment of acne vulgaris. Materials and Methods: This prospective, randomized, open-label, comparative study was conducted on sixty patients with moderate-to-moderately severe (Grade II and III) acne vulgaris. Patients were randomly assigned to two treatment groups, A and B. Patients in Group A received 50 mg minocycline orally daily whereas patients in Group B were given 500 mg azithromycin orally once a day for 3 consecutive days/week. Both the groups were advised topical application of 2.5% topical benzoyl peroxide gel in the night. The total duration of treatment was 3 weeks. All the patients were evaluated at the end of 3 weeks. Statistical analysis was done using Wilcoxon signed-rank test and Mann–Whitney U-test. Results: Group A showed a reduction in lesional count of 39.7% for noninflammatory papules, 65.11% for inflammatory papules, and 52.22% for pustules. Similarly, Group B showed 30.39%, 54.69%, and 57.76% reduction in lesional count for noninflammatory papules, inflammatory papules, and pustules, respectively. Conclusions: Both minocycline and azithromycin were equally effective and safe for the treatment of acne vulgaris.