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Comparison of the Efficacy of Azithromycin Versus Doxycycline in Acne Vulgaris: A Meta-Analysis of Randomized Controlled Trials

Authors
Kim, Jung EunPark, A. YoungLee, Sung YulPark, Young LipWhang, Kyu UangKim, Hyun-Jung
Issue Date
Aug-2018
Publisher
대한피부과학회
Keywords
Acne vulgaris; Azithromycin; Doxycycline; Meta-analysis
Citation
Annals of Dermatology, v.30, no.4, pp 417 - +
Journal Title
Annals of Dermatology
Volume
30
Number
4
Start Page
417
End Page
+
URI
https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/5764
DOI
10.5021/ad.2018.30.4.417
ISSN
1013-9087
2005-3894
Abstract
Background: Acne vulgaris is one of the most common disorders of the pilosebaceous unit. Although doxycycline is considered to be a first-line anti-acne antibiotic, various other antibiotics have been tried due to its adverse effects and contraindications. We performed a meta-analysis of randomized controlled trials (RCTs) that compared the efficacy of oral azithromycin pulse therapy with that of oral daily doxycycline in the management of moderate to severe acne vulgaris. Methods: Five scientific databases (MEDLINE, EMBASE, Cochrane Library, SCOPUS, and Web of Science) were searched to identify relevant studies. A review of 1,341 publications produced six RCTs that met our predefined inclusion criteria. The clinical outcome measures were remaining acne lesion counts, patients' self-assessment of treatment, and the investigators' assessment of treatment after 12 weeks. Results: We included six studies assessing 906 patients with moderate to severe acne vulgaris. Meta-analyses of clinical outcome measures revealed no significant difference between the two groups regarding remaining acne lesion counts (p = 0.27), patients' self-assessment of treatment (p = 0.67), and the investigators' assessment of treatment (p = 0.32). The incidence of severe adverse events leading to the discontinuation of therapy was higher in the doxycycline daily therapy group when compared with the azithromycin pulse therapy group. Conclusion: This study indicates that azithromycin pulse therapy is equivalent to doxycycline at 12 weeks in the efficacy of the treatment for moderate to severe acne vulgaris Therefore, oral azithromycin pulse therapy may be a good alternative to doxycycline in the management of acne for those unable to tolerate doxycycline.
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