Comparison of efficacy and safety of oral azithromycin and oral doxycycline in acne vulgaris

Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit with considerable psychosocial impact. Oral azithromycin or oral doxycycline can be used for the management of moderate and severe acne vulgaris. However, there is no consensus on which antibiotic is superior and the optimal dose for management.Methods: A prospective randomized interventional study was carried out among 120 patients of moderate to severe acne vulgaris. The patients were randomized into group A and B. While group A was prescribed oral azithromycin 500 mg three times a week, group B was given oral doxycycline 100 mg daily for 12 weeks. Topical clindamycin twice daily application was also given. Global Acne Grading Scale (GAGS) score was recorded at baseline and at 2nd, 4th, 8th and 12th weeks.Results: GAGS score at baseline in azithromycin (n = 53) and doxycycline (n = 55) group was 31.98±4.49 and 30.63±3.78 respectively (p value >0.05). 83.91±6.83% (p <0.001) and 81.87±6.75% (p <0.001) improvement was seen in azithromycin group and doxycycline group after 12 weeks of treatment. However, there was no difference in the GAGS score between the groups at any follow-up (p value >0.05). 15.09% patients in azithromycin group and 20% patients in doxycycline group reported adverse effects. The most commonly reported adverse effect was diarrhoea. All adverse effects were of ‘mild’ category and causality assessment was ‘possible’.Conclusions: Oral azithromycin is equally efficacious but safer alternative to oral doxycycline for the management of acne vulgaris.

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Comparing the efficacy of intense pulsed light combined with oral azithromycin versus oral azithromycin alone in the treatment of moderate to severe papulopustular acne vulgaris

Medical Journal of Tabriz University of Medical Sciences and Health Services ◽

10.34172/mj.2021.001 ◽

2021 ◽

Vol 42 (6) ◽

pp. 621-626

Author(s):

Niloofar Afshari ◽

Mehdi Amirnia ◽

Davod Ahmadi ◽

Saeed Kashefi ◽

Vahideh Aghamohammadi

Keyword(s):

Complete Remission ◽

Therapeutic Option ◽

Acne Vulgaris ◽

Intense Pulsed Light ◽

Pulsed Light ◽

Field Methods ◽

Severe Acne ◽

Group A ◽

Group B ◽

Oral Azithromycin

Background: Rising follicular keratin secretion, increasing sebum production, and Propionibacterium acnes are among the main etiology of acne vulgaris formation. Antibiotics are the predominant conventional treatment of acne. Antibiotic resistance is the main problem in the ordinary treatments of acne. Therefore, newer treatments are necessary. Intense pulsed light (IPL) is a novel therapeutic option with rapid application in this field. Methods: Patients referred to us were randomized into two groups: group A (cases) and group B (controls). In addition to conventional antibiotic therapy, IPL was prescribed to group A while azithromycin alone was prescribed to group B. IPL treatment was performed weekly for five weeks and the patients were followed for three months. Declining inflammatory lesions count after the intervention was considered the remission scale. Results: In group A, moderate, partial, and complete remission occurred in 4, 9, and 7 patients, respectively. In group B, moderate, partial, and complete remission occurred in 10, 7, and 3 patients, respectively. Statistically, the remission difference was meaningful between the two groups. Conclusion: IPL with conventional antibiotics is an effective treatment choice in moderate to severe acne vulgaris but also is a more accelerating agent in treatment versus antibiotics alone.

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COMPARISON OF MONTHLY PULSE OF ORAL AZITHROMYCIN WITH DAILY DOXYCYCLINE IN THE TREATMENT OF MODERATE ACNE VULGARIS

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71isuppl-1.2926 ◽

2021 ◽

Vol 71 (Suppl-1) ◽

pp. S268-72

Author(s):

Muhammad Mudassir ◽

Ali Amar ◽

Naeem Raza ◽

Ayesha Khokhar ◽

Adeel Siddiqui ◽

...

Keyword(s):

Acne Vulgaris ◽

Severity Index ◽

Post Treatment ◽

Military Hospital ◽

Dermatology Department ◽

Oral Doxycycline ◽

Group A ◽

Pre Treatment ◽

Group B ◽

Oral Azithromycin

Objective: To compare oral Azithromycin with oral Doxycycline in treatment of moderate Acne Vulgaris. Study design: Randomized control trial Place and duration of the study: Dermatology Department , Pak Emirates Military Hospital, Rawalpindi from 1st August 2017 till 31st January 2018. Materials and methods: A total of 92 patients with moderate Acne were selected from Dermatology outpatient department (OPD) Pak Emirates Military Hospital Rawalpindi, after written informed consent. Patients were randomly allocated to one of the two treatment groups: Group A and Group B by lottery method. Patients in group A were given oral Azithromycin 500 mg daily for four consecutive days each month for 03 months and patients in group B were given oral Doxycycline 100 mg daily for 03 months. Patients were reviewed monthly for 03 months and Acne Severity Index (ASI) was recorded at baseline, at one month and three months. The primary outcome measured was more than 50% decrease from baseline in ASI within 3 months of treatment, using Global Acne Grading System (GAGS). Results: Mean age of patients in group A was 21.80 + 4.64 years whereas mean age of patients in group B was 21.61 + 4.48 years. In group A mean pre-treatment ASI was 24.83 + 3.15 and mean post-treatment ASI was 10.15 + 1.7. In group B mean pre-treatment ASI was 25.30 ± 2.96 and mean post-treatment ASI was 9.86 + 1.58. Conclusion: Azithromycin is comparable to Doxycycline in terms of mean change in ASI, in the treatment of moderate Acne Vulgaris.

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SINONASAL POLYPOSIS

The Professional Medical Journal ◽

10.29309/tpmj/18.4485 ◽

2018 ◽

Vol 25 (10) ◽

pp. 1581-1586

Author(s):

Farhan Salam ◽

Ejaz Ahmad ◽

Muhammad Salman Haider Qureshi ◽

Muhammad Aslam Khan

Keyword(s):

Nasal Polyposis ◽

Controlled Trial ◽

Chronic Inflammatory Disease ◽

P Value ◽

Entire Study ◽

Sense Of Smell ◽

Study Duration ◽

Group A ◽

Group B ◽

Sinonasal Polyposis

Introduction: Nasal polyposis (NP) is a chronic inflammatory disease involvingmucous membrane in paranasal sinuses and nose. It presents as gelatinous, semitranslucent,smooth, pedunculated pear or round shaped masses comprising of inflamed mucosa thatout-pouches into nose. The available surgical options are Functional Endoscopic SinusSurgery (FESS) and Conventional Intranasal Polypectomy (CIP). The study aims to compareFESS and CIP in sinonasal polyposis patient in term of symptomatic improvement. StudyDesign: Randomized controlled trial. Setting: Department of head n’ neck surgery andOtorhinolaryngology, Pakistan Institute of Medical Sciences, Islamabad. Period: 01-01-2015 to20-08-2015. Methodology: A total of 84 patients presenting with nasal polyposis were enrolled.Out of these 84 patients, 42 patients were randomly selected for FESS (Group-A). Rest of the42 patients were selected for CIP (Group-B). All the information recorded on the Performawas entered and analysed using SPSS version 17. The entire study duration was 31 weeks.Regarding ethical consideration, the study was approved from ethics committee of hospital.Informed consent was obtained from the study participants. Moreover, confidentiality andanonymity of subjects was assured. The patients were followed-up for 2 months duration. Theentire study duration was about 8 months. Results: On the basis of scoring of nasal obstruction,in FESS Group-A, 32 (76.19%) patients had completely patent nose after two months and only10 (23.81%) patients had partially blocked nose. On the other hand in CIP Group-B, only 16(38.10%) patients had completely patent nose while 26 (60.90%) patients had partially blockednose after two months. The comparison of sense of smell between both groups also showedthat the outcome of Group-A was significantly (p-value = 0.000) better as compared to Group-B.The complete sense of smell was found present in 37 (88.10%) patients in group A in contrastwith 19 (45.23%) patients in group B. Conclusion: FESS seems to be a better treatment optionfor sinonasal polyposis than conventional intranasal polypectomy. However study with largerpopulation size and longer follow up duration is recommended to rationalize the results.

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Efficacy and tolerability of 0.1% tazarotene cream and 0.05% tretinoin cream in the treatment of acne vulgaris

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v8i1.28916 ◽

2016 ◽

Vol 8 (1) ◽

pp. 24

Author(s):

Mohammad Habibur Rahman ◽

Md. Shahidullah Sikder ◽

Lubna Khondker

Keyword(s):

Treated Patient ◽

Acne Vulgaris ◽

Chronic Inflammatory Disease ◽

Controlled Clinical Trial ◽

Base Line ◽

Excellent Response ◽

Group A ◽

Group B ◽

Medical University

Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicles that is seen primarily in adolescents.Objective: To compare the efficacy of 0.1 % tazarotene cream and 0.05% tretinoin cream in the treatment of mild to moderate acne vulgaris.Methods: A randomized controlled clinical trial was done in the department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.Results: At base line mean number of comedones in group A and group B was 12.77 ± 4.01 and 11.80 ± 3.93 respectively (p=0.350) and at final follow up 4.17 ± 4.02 and 3.47 ± 4.00(p=0.501). At base line mean number ofpapules in group A and group B was 17.30 ± 10.29 and 18.57 ± 13.88 respectively (p=0.690) and at final follow up 7.63 ± 8.08 and 7.73 ± 9.98 (p=0.966). At base line mean number of pustules in group A and group B was 0.50 ± 1.33 and 0.53 ± 1.28 respectively (p=0. 922) and at final follow up 0.07 ± 0.37 and 0.00 (p=0.326). At baseline mean of total acne score was 30.57 ± 13.62 and 30.90 ± 17.17 in group A and B(p=0.934) and at final follow up it was 11.87 ± 12.04 and 11.20 ± 13.85 respectively in group A and B(p=0.846). At 1st follow up 3.3% of both group got excellent response, at 2nd follow up 13.3% of group A and 30.0% of group B got excellent response, and at final follow up 56.7% of group A and 63.3% of group B achieved excellent response. About 73.33% oftretinoin treated patient and 60% oftazarotene treated did not experience any side effects.Conclusion: It can be concluded that 0.1 % tazarotene cream and 0.05% tretinoin cream is individually effective and tolerability of 0.1 % tazarotene is comparable to 0.05% tretinoin in the treatment of mild to moderate acne vulgaris.

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Analgesic Effect of Caudal Bupivacaine with or without Clonidine in Pediatric Patient

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v16i41.1647 ◽

2019 ◽

Vol 16 (41) ◽

pp. 428-433

Author(s):

Sharad Khakurel ◽

Shanta Sapkota ◽

Anuj Jung Karki

Keyword(s):

Inguinal Hernia ◽

Adverse Effects ◽

Lower Limb ◽

P Value ◽

Single Shot ◽

Unilateral Inguinal Hernia ◽

Caudal Analgesia ◽

Group A ◽

Group B ◽

Double Blinded

Background: Caudal analgesia has long been the cornerstone to successful pain management in children undergoing abdominal and lower limb surgeries. Its analgesic duration with single shot injection is however limited. So adjuvants are used with local anesthetics in an attempt to increase the duration of caudal analgesia. This study aims to investigate the duration of analgesia provided by Clonidine when added to caudal Bupivacaine.Methods: A randomized, double blinded, comparative study was conducted on 64 patients, aged two to seven years, scheduled for unilateral inguinal hernia repair. Patients were randomly allocated into two groups of 32 each, with group A receiving bupivacaine two milligram/kilogram and group B receiving bupivacaine two milligram/kilogram with one microgram/kilogramclonidine, (total volume of injectate was one milliliter/kilogram). Duration of analgesia, hemodynamic response and adverse effects, if any were noted.Results: Mean duration of analgesia in group A was 264.12 ± 68.77 minutes and in group B was 520 ± 57.37 minutes, p-value <0.001.Incidence of vomiting was 9% in group A compared to 6% in group B.Conclusions: Clonidineas an adjuvant to caudal bupivacaine prolongs the duration of analgesia without increasing the adverse effects.Keywords: Bupivacaine; caudal analgesia; clonidine;pediatric.

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Comparative Study to Evaluate Efficacy and Safety for Management of Neuropathic Pain with Gabapentin, Pregabalin, and Amitriptyline

10.53350/pjmhs211592995 ◽

2021 ◽

Vol 15 (9) ◽

pp. 2995-2998

Author(s):

Abdulrahman Alharbi

Keyword(s):

Neuropathic Pain ◽

Adverse Effects ◽

Rating Scale ◽

P Value ◽

Lumbosacral Spine ◽

X Rays ◽

Open Label ◽

Significant Difference ◽

Group A ◽

Group B

Background: Current treatments for neuropathic pain (NeP) are tricyclic antidepressants (TCA), such as pregabalin and gabapentin are first-line drugs for the management of NeP complaints. Current treatment for the management of neuropathic pain is often sub-standard. Methods: It's a three-arm, prospective, comparative, open-label study. A total of 270 patients with persistent lumbar radiculopathy were randomized into three groups based on clinical examination, symptoms, X-rays, and MRI scans of the lumbosacral spine. Patients in Groups A and B got Gabapentine 300 mg, Pregabaline 75 mg, and Amitriptyline 75 mg, respectively. Results: The mean NPRS score at two months was 3.72 ± 2.65 for Group A, 3.63 ± 2.65 for Group B, and 5.21 ± 2.65 for Group C. The F-value was 6.63, and the p-value was 0.001, which was statistically significant. As compared to the other two treatment groups, the subjects in Group 3 saw a significant difference. ‎ The adverse effects reported occurrence of dizziness was significantly more in group B with 21 patients (23.33%) as compared to group A with 11 patients (12.22%) and group C with 4 patients (4.44%), [p=0.041). The sedation occurred in 28 patients of group B (31.11%), which was significantly more than group A i,e, in 23 patients (25.55%) and group C, i.e., 22 patients (24.44%), [P=0.036]. Conclusions: In patients with NeP Thus, in conclusion, three groups Gabapentine, Pregabaline, and Amitriptyline, are equally efficacious in relieving pain in NeP. Pregabalin has advantages in terms of Numeric pain rating scale (NPRS) score over the Gabapentine and Amitriptyline. Gabapentine has fewer reported adverse effects and hence better patient compliance on long-term use. Keywords: Gabapentine, Amitriptyline, Pregabalin, Neuropathic pain

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Effect of Ginger-Naproxen on Knee Osteoarthritis: A Clinical Study

Journal of Bahria University Medical and Dental College ◽

10.51985/fagq7533 ◽

2021 ◽

Vol 11 (01) ◽

pp. 17-21

Author(s):

Mehtab Munir ◽

Khalid Mustafa Memon ◽

Sajid Abbas Jaffri ◽

Hasan Ali

Keyword(s):

Adverse Effects ◽

Knee Osteoarthritis ◽

Medical Center ◽

P Value ◽

Medicine Department ◽

National Medical ◽

Significant Difference ◽

Group A ◽

Group B ◽

Naproxen 500Mg

Objective: To evaluate clinical efficacy and safety of ginger with naproxen, in treating knee osteoarthritis. Study design and setting: Randomized clinical trial conducted in medicine department OPD of National Medical Center, Karachi from 21st September 2018 till 31st March 2019. Methodology: This study was conducted on 60 patients of knee osteoarthritis. After written informed consent, the patients were randomized to two groups. Group A received tablet naproxen 500mg and capsule ginger 550mg, twice daily and group B was given tablet naproxen 500mg twice daily. Total 53 patients finished the study (group A: n=27 and group B: n=26). Baseline pain (Visual Analogue Scale) and Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) scores were noted at the beginning of study and reassessed after 6 weeks of the intervention. Safety profile of the drugs was assessed by observing adverse effects. Independent t-test was applied to check difference between the two groups. Statistical analysis was performed using SPSS version 23.0. P-value < 0.05 was considered as statistically significant. Results: Before the intervention no significant difference was observed in two groups. However significant difference was observed between the groups in pain (p=0.019) and WOMAC (p=0.020) scores after 6 weeks of intervention. Moreover there was no significant difference (p=0.914) in occurrence of adverse effects between the two groups at the end of 6 weeks of study. Conclusion: Ginger with naproxen can effectively treat pain and stiffness in knee osteoarthritis without added adverse effects when compared with naproxen alone.

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Comparative Efficacy of Phenytoin Versus Lidocaine in the Management of Intractable Seizure in Neonate

Journal of Dhaka Medical College ◽

10.3329/jdmc.v25i2.33973 ◽

2017 ◽

Vol 25 (2) ◽

pp. 94-99

Author(s):

Shah Abdullah Al Baqui ◽

Md Tafazzal Hossain Khan ◽

Md Abid Hossain Mollah ◽

Manisha Banerjee ◽

Md Mahfuzur Rahman ◽

...

Keyword(s):

Adverse Effects ◽

Length Of Hospital Stay ◽

Medical Emergency ◽

Neonatal Seizure ◽

P Value ◽

College Hospital ◽

Lidocaine Group ◽

Medical College ◽

Group A ◽

Group B

Background : Intractable neonatal seizure are common acute medical emergency in neonatal period than at any other period of life. In our daily practice treatment of intractable neonatal seizures still relies primarily on phenytoin, despite an estimated efficacy of less than 50% and concern over neurodegenerative side effects. Several studies indicate value for lidocaine as an anticonvulsant in the treatment of intractable neonatal seizure.Aim : The objective of this study was to compare the efficacy of Phenytoin with Lidocaine in the management of intractable seizure in neonate.Methodology : A Randomized control trial was carried out in the Department of Neonatology, Dhaka Medical College Hospital (DMCH), Dhaka between July 2013 to June 2014. A total of 78 newborn with neonatal seizure. admitted in SCABU & not responding to total doses of Inj. Phenobarbital (40 mg/kg) were included in the study and were randomly assigned to either Inj. Lidocaine (Group A=39) or to Inj. Phenytoin (Group B=39). The main outcome variables were control of seizure, adverse effects, time of cessation of seizure.Results : The study demonstrated that intractable seizure of 24 neonates (75%) were controlled with Inj. Lidocaine and intractable seizure of 20 neonates (57.1%) were controlled with Inj. Phenytoin(P-Value 0.124). Adverse effects of drugs such as apnea, bradycardia, drowsiness and lethargy were observed in 4 patients (12.5%) of Lidocaine group (Group A) and 10 (28.6%) of Phenytoin group (Group=B) (P-Value 0.106). Time required for cessation of intractable seizures were nearly similar in both groups. In group A 75% of patients responded within 24 hours and in group B 71% patients responded in same duration(P-Value 0.931). Length of hospital stay was less in phenytoin group compare to lidocaine group(P-Value 0.352). None of the following results were statistically significant.Conclusion : The study concluded that Inj. Lidocaine is similar to Inj. Phenytoin in controlling intractable neonatal seizure.J Dhaka Medical College, Vol. 25, No.2, October, 2016, Page 94-99

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Efficacy of Oral Azithromycin versus Doxycycline in the Treatment of Acne Vulgaris

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v18i2.38908 ◽

2021 ◽

Vol 18 (2) ◽

pp. 59-62

Author(s):

Abhishek Arjel ◽

Kumar Pokhrel ◽

Sapana Sharma

Keyword(s):

Acne Vulgaris ◽

College Teaching ◽

Medical College ◽

Significant Difference ◽

Common Skin ◽

Group A ◽

Efficacy Assessment ◽

Grade Ii ◽

Group B ◽

Oral Azithromycin

Introduction: Acne vulgaris is one of the most common skin disease affecting adolescence of either sex, globally. Antibiotics like macrolides and tetracycline have been used with good results, studies comparing their efficacy are lacking. The present study compare the efficacy of Azithromycin v/s Doxycycline in acne vulgaris. Aims: To compare the efficacy of Azithromycin and Doxycycline in the treatment of acne vulgaris. Methods: This is a prospective hospital based comparative study, conducted on 80 patients attending outpatient department of Dermatology, Nepalgunj Medical College Teaching Hospital with acne vulgaris from July 2019 to April 2020. Patient were divided alternately into two groups, Group A received Azithromycin (n=40) and Group B Doxycycline (n=40) and compared the effects of treatment at 6 and 12 weeks. Efficacy assessment was done according to simple acne grading system. Results: Acne was predominant in female (62.5%) as compared to male (37.5%). Patient between 16 to 20 years age group were more prone to acne (47.5%). Most of the patients had Grade II acne before treatment in both groups (Azithromycin 52.5%, Doxycycline 55%). After the treatment most of them improve to Grade I at 6 weeks (Azithromycin 50%, Doxycycline 55%) and to Grade zero at 12 weeks (Azithromycin 42.5%, Doxycycline 67.5%).There was no statistically significant difference in treatment efficacy between the two groups at 6 weeks but at 12 weeks efficacy of Doxycycline was significantly better than Azithromycin. Conclusion: Both oral Azithromycin and Doxycycline when given for treatment of acne vulgaris the analysis showed good improvement after 6 weeks of treatment but there was no statistically significant difference in the improvement in both groups (p 0.771). However after 12 weeks patient receiving Doxycycline showed statistically significant improvement (p 0.035) in comparison to the patients receiving Azithromycin.

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Comparative Efficacy and Safety of Low Dose versus High Dose Isotretinoin in Severe Acne Vulgaris Patients

Journal of Islamabad Medical & Dental College ◽

10.35787/jimdc.v8i1.309 ◽

2019 ◽

Vol 8 (1) ◽

pp. 18-22

Author(s):

Maria Syed ◽

Syed Afaq Ahmed

Keyword(s):

Side Effects ◽

Low Dose ◽

Acne Vulgaris ◽

High Dose ◽

High Dose Regimen ◽

Severe Acne ◽

Dose Oral ◽

Group A ◽

Oral Isotretinoin ◽

Group B

Background: Oral isotretinoin is the recommended treatment for acne vulgaris, a skin disease especially common in teenagers and adolescents. This study was designed to compare the efficacy and safety of low dose with high dose isotretinoin in severe acne vulgaris patients.Material and Methods: This randomized controlled trial included 110 patients with a clinical diagnosis of acne vulgaris. They were divided into two groups. Both groups were matched for age (mean 18.2±3.7 vs 17.6±3.2 years), weight (mean 58±10.2 vs 60.7±9.3 Kg), gender and disease duration (3±1.1 vs 3±1.0 years). Group A received low dose oral isotretinoin (20 mg/day) while group B received standard high dose regimen (1mg/kg/day). All patients were followed up for 16 weeks to assess efficacy (assessment of complete remission) and safety (mucocutaneous side effects). All calculations were performed using SPSS v. 16 with p value <0.05 considered as statistically significant.Results: There was no statistically significant difference in efficacy. However, significantly fewer mucocutaneous side effects were reported in group A (80%) as compared to group B (100%). This safety profile spectrum was observed across all pre-defined subsets i.e chielitis (78.1% vs 98.2%), dry skin (69.1% vs 92.7%), dry mouth (47.2% vs 72.7%) and facial rash (12.7% vs 30.9%).Conclusion: In patients with severe acne vulgaris, efficacy (complete remission) of low dose oral isotretinoin is almost equal to conventional high dose regimen but it is statistically superior in terms of safety (mucocutaneous side effects).

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