Comparison of the therapeutic efficacy of doxycycline and azithromycin in patients with mild acne - how old is it?

Acne is the most common skin problem among adolescents and young people. In recent decades it has been proven that the use of antibacterial drugs systematically plays a major role in the treatment of acne patients who have inflammatory elements. In some cases, systemic antibiotic therapy causes side effects, which contributes to a decrease in patient compliance.

The purpose of a randomized, double-blind, controlled clinical trial in Iran was to compare the efficacy and safety of azithromycin and doxycycline in the treatment of moderate acne and to study the effect of the patient's age on the results of the treatment.

The study involved 100 patients with moderate forms of acne vulgaris, who sought outpatient care at a dermatology clinic. The patients were randomized into 2 equivalent groups A and D: group A received azithromycin at a dose of 500 mg per day for 4 consecutive days per month for 3 consecutive months; Group D patients took doxycycline 100 mg daily for 3 consecutive months.

The number and types of lesions were recorded during the initial visit and at the end of each month during treatment and for 90 days after the end of treatment. Also at the initial visit and at the end of the 3rd month after the start of treatment, Michaelson's acne severity score was assessed. To determine the incidence of relapse, patients were observed for 3 months after stopping treatment.

It turned out that the two antibacterial drugs had comparable clinical efficacy in treating mild forms of acne. In group A, there were no significant treatment side effects and in group D, these complications were minimal. At the same time, doxycycline was statistically significantly more effective in patients over 18 years of age.

Thus, azithromycin is at least as effective as doxycycline in the treatment of moderate to severe forms of acne, but in patients over 18 years of age, doxycycline is preferred.