An analytical study on the use of Adapalene and Azithromycin for Acne vulgaris

Abstract

Introduction: Acne vulgaris is a common dermatological disorder affecting approximately 85 -90% of individuals between 12 and 24 years of age. In this study, the aim is to compare the efficacy of the macrolide: azithromycin given orally as the sole treatment versus a new retinoid adapalene used topically as the sole treatment, versus both given together. The new international consensus guidelines state that, topical retinoids, alone or in combination are regarded today as the first line treatment for both comedogenic and mild inflammatory acne vulgaris.Methods: Ninety new patients with inflammatory acne vulgaris attending the Dermatology OPDs at local randomly selected secondary & tertiary medical care centres were incorporated in this study. They were randomly allocated into three groups. Group 1 received topical adapalene (0.01%) gel, group 2 received oral azithromycin, whereas group 3 was given a combination of these two. The patients were treated for a period of 12 weeks, being reviewed every fortnightly. The results obtained were analyzed in detail using statistical methods.Results: The combination of adapalene and azithromycin caused the highest reduction in the inflamed lesion count followed by azithromycin given singly. monotherapy with adapalene was also used. This difference in efficacy was small and not statistically significant . Azithromycin lead to a rapid reduction in the inflammatory lesion count, but it had negligible action on non-inflamed lesions.Conclusion: The treatment group 3 (combination of topical adapalene and oral azithromycin) showed more improvement in terms of inflammatory lesion count than the other two groups, small number of cases in the present study might have prevented this trend from assuming statistical significance. Topical adapalene has a very good comedolytic effect, while oral azithromycin has a negligible one. The faster reduction in acne lesions when azithromycin was added to the therapeutic regime, suggests that the usage of this drug from the beginning of treatment could lead to a faster clinical response than that achieved by topical therapy alone.