zithromax and Acne-Vulgaris

Topics: Acne Vulgaris; Administration, Oral; Anti-Bacterial Agents; Azithromycin; Drug Costs; Drug-Related Side Effects and Adverse Reactions; Erythromycin; Evidence-Based Medicine; Humans; Minocycline

In 1987, synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome was proposed as an umbrella term for a group of diseases with similar musculoskeletal manifestations, in particular hyperostosis of anterior chest wall, synovitis, and multifocal aseptic osteomyelitis, observed in association with dermatologic conditions such as palmoplantar pustulosis, severe acne, and hidradenitis suppurativa. Despite recent advances in our understanding of the epidemiologic, pathophysiologic, and immunogenetic mechanisms involved in SAPHO syndrome, etiopathogenesis remains poorly understood. Propionibacterium acnes, the microorganism associated with acne, has been recovered on bone biopsy in some patients, but the possible pathogenetic role of an infectious agent in a genetically predisposed individual, resulting in exaggerated inflammatory response as "reactive osteitis," is a largely unproven hypothesis. The newly available whole-body MRI will assist early diagnosis by detecting multifocal osteitis lesions, some of them asymptomatic, in axial (anterior chest wall, spine, and jaws) and nonaxial sites. Moreover, outcomes are vastly improved by treatment with bisphosphonates and tumor necrosis factor-alpha antagonists.

Topics: Acne Vulgaris; Acquired Hyperostosis Syndrome; Anti-Bacterial Agents; Azithromycin; Bone Density Conservation Agents; Diphosphonates; Humans; Hyperostosis; Magnetic Resonance Imaging; Osteitis

Topics: Acne Vulgaris; Administration, Oral; Anti-Bacterial Agents; Azithromycin; Dermatologic Agents; Humans; Isotretinoin

Acne vulgaris is a common dermatologic disorder which results in psychological consequences. Inflammatory responses play an important role in the development of inflammatory acne lesions. Recently, many studies have demonstrated anti-inflammatory effects of statins; thus, the aim of this study was to evaluate the efficacy of oral and topical Simvastatin as adjunct therapy in the treatment of acne vulgaris.. A total of 76 patients with moderate to very severe acne vulgaris, all receiving oral azithromycin (250 mg, 3 times a week, orally) and topical benzoyl peroxide gel (5%, once daily) were assigned to three groups: 1) Oral group received 20mg/day of oral simvastatin and blank solution, 2) Topical group received simvastatin 1% topical solution and oral placebo, 3) Placebo group received oral placebo and blank solution. The severity of acne was determined by global acne grading system (GAGS) at baseline and after 8 weeks of treatment.. Comparing the three groups showed that topical simvastatin was associated with greater decrease in acne severity as compared with those of oral and placebo groups. Moreover, the oral simvastatin appeared to be more efficacious as compared with placebo group (P value<0.001). Oral and topical simvastatin were well tolerated in almost all patients.. Although preliminary, the results of this study showed that oral and topical statins, drugs with anti-inflammatory properties, can be considered as effective treatment for acne vulgaris as an adjunct to standard treatment. However, further studies with larger sample size, using improved formulations of topical simvastatin are needed to confirm these results.

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Dermatologic Agents; Double-Blind Method; Female; Humans; Male; Simvastatin; Treatment Outcome; Young Adult

Acne vulgaris is one of the most common skin disorders. It mainly affects adolescent, though may present at any age. The conventionally used dose of isotretinoin in acne causes significant dose-related adverse effects. Low-dose isotretinoin has been used successfully, in mild to moderate papulopustular acne. To observe whether the addition of an antibacterial enables use of isotretinoin in low doses even in moderate to severe acne. An open-label, non-comparative study was carried out for 24 weeks. Eighty two teenagers with moderate to severe papulo-pustular acne vulgaris were enrolled. These patients were treated with a combination of low-dose isotretinoin (0.3mg/kg/day) and pulsed oral azithromycin (500mg/day over three consecutive days in each week for one month. No topical treatment was permitted. Response to treatment was assessed at monthly intervals and was recorded as a percentage decrease in overall severity of disease. Treatment was continued to complete clearance of lesions or to 24 weeks. All patients were also evaluated at six months post-treatment. Eighty (97.56%) patients had complete clearance of disease activity after treatment duration of 24 weeks. Only two (2.43%) patients had a relapse of disease during the post-treatment follow-up period. Four (4.87%) patients were observed with adverse effects. Three (3.65%) patients had initial aggravation of disease that was managed with oral betamethasone and this disappeared with continuation of treatment. A combination of low-dose isotretinoin and oral azithromycin pulse is effective in moderate to severe acne.

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Anti-Bacterial Agents; Azithromycin; Child; Dermatologic Agents; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Humans; Isotretinoin; Male; Pulse Therapy, Drug; Recurrence; Treatment Outcome

Different immunologic mechanisms contribute to development of inflammation in acne vulgaris and immunologic effect of levamisole has been demonstrated.. The aim of this study was to compare azithromycin and levamisole with azithromycin alone in the treatment of acne vulgaris.. An investigator-blind clinical randomized prospective 2 months study was designed. 169 acne patients presenting in our outpatients clinic were randomly allocated to two treatment groups: azithromycin and levamisole (Group 1) and azithromycin alone (Group 2). 148 patients completed the duration of the study and their clinical responses were evaluated and compared by using monthly photographic records.. Mean reduction rates for the number of papules, pustules and both of them, in Group 1 were 73.72%, 82.69% and 76.93%, respectively, and 68.39%, 70.89% and 69.32% in Group 2 (p < 0.05). Also, mean reduction rates for the number of nodules, cysts and both of them in Group 1 were 80.97%, 89.75% and 82.35%, respectively, and 58.54%, 54.55% and 57.99% in Group 2 (p < 0.05).These differences between two groups were statistically significant in favor of azithromycin and levamisole (Group 1) (p < 0.05).. According to this study azithromycin plus levamisole may be more effective than azithromycin alone in decreasing of inflammatory acne lesions especially in nodulocystic form. So, regarding the low cost and side effect profile of levamisole, we suggest to consider combination of levamisole with azithromycin while facing acne patients at least with more inflammatory lesions especially when there is any contraindication for isotretinoin.

Topics: Acne Vulgaris; Adjuvants, Immunologic; Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Child; Drug Administration Schedule; Drug Therapy, Combination; Female; Humans; Levamisole; Male; Patient Satisfaction; Single-Blind Method; Surveys and Questionnaires; Treatment Outcome; Young Adult

Acne vulgaris is the most common dermatological disorder in adolescence and young adults. In past decades, systemic antibiotics have had the main role in the treatment of acne patients with inflammatory papules and cysts. They are sometimes associated with side effects, contributing to reduced compliance.. This study aimed at comparing the efficacy and safety of oral azithromycin and doxycycline in the treatment of moderate acne vulgaris, considering the age of patients as an influencing parameter.. In a randomized, double-blind, clinical trial, 100 patients with moderate acne vulgaris who attended the outpatient dermatology clinic were evaluated during a 15-month period. They were randomized into two equal groups: A and D. Patients in group A received oral azithromycin (500 mg daily, 4 consecutive days per month for 3 consecutive months) and patients in group D took doxycycline (100 mg daily for 3 consecutive months). The number and types of lesions (all over the body) were determined at baseline and at the end of each month for 90 days afterwards. Michaelson's acne severity score was also determined at baseline and at the end of the third month after initiating treatment. Patients were followed up for another 3 months after discontinuation of treatment to determine the recurrence rate.. Both antibiotics were comparably effective in the treatment of moderate acne vulgaris. There was no significant side effect in the A group and the complications were minor in the D group. Doxycycline was significantly more effective in patients older than 18 years.. Azithromycin is at least as effective as doxycycline in the treatment of moderate acne vulgaris; however, in patients older than 18 years doxycycline is better.

Topics: Acne Vulgaris; Adolescent; Adult; Age Factors; Anti-Bacterial Agents; Azithromycin; Double-Blind Method; Doxycycline; Female; Humans; Male; Recurrence; Severity of Illness Index; Young Adult

The conventionally used dose of isotretinoin in acne causes significant dose-related adverse effects. Low-dose isotretinoin has been used successfully in mild to moderate papulopustular acne. Although isotretinoin acts against all mechanisms of acne formation, it has no significant direct antimicrobial effect.. To test whether the addition of an antibacterial enables use of isotretinoin in low doses even in moderate to severe acne.. This was a preliminary open-label, prospective, non-comparative, single-centre study carried out in a tertiary-care referral hospital. Seventy patients with grade 3 and 4 acne according to the US FDA global score were included in the study between October 2005 and December 2007. These patients were treated with a combination of low-dose isotretinoin (0.3 mg/kg/day) and pulsed oral azithromycin (500 mg/day over three consecutive days every 2 weeks). Response to treatment was assessed at monthly intervals and was recorded as a percentage decrease in overall severity of disease. Treatment was continued to complete clearance of lesions or to 16 weeks, whichever came later.. Sixty-two (93.9%) of 66 eligible patients had complete clearance of disease activity after a mean treatment duration of 21 weeks. The mean total cumulative dose of isotretinoin was 49.6 mg/kg. Seven (11.3%) patients had a relapse of disease during the post-treatment follow-up period. Fifty-three adverse effects were observed. Three patients had initial aggravation of disease that was managed with prednisolone and disappeared with continuation of treatment.. A combination of low-dose isotretinoin and oral azithromycin pulse is effective in severe acne and has a reasonably acceptable adverse-effect profile and low post-treatment relapse rates.

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Humans; Isotretinoin; Male; Prospective Studies; Recurrence; Treatment Outcome; Young Adult

Azithromycin is an azalide analogous to erythromycin; it has an anti-inflammatory action that prevents the growth of Propionibacterium acnes, a major microorganism involved in the pathogenesis of inflammatory acne.. An open, multicentric, non-comparative study was performed with 57 patients to evaluate the efficacy, tolerability and safety of azithromycin in the treatment of grade 2 inflammatory vulgar acne, using a regimen of three monthly pulses of 500 mg for 3 consecutive days. The efficacy was evaluated using the Physician's Global Evaluation of Clinical Response Scale. The drug's safety was monitored by standard laboratory analyses and by the incidence of adverse events.. Azithromycin showed a significant statistical reduction of the number of lesions in the different regions of the face between the basal and final visits (p<0.001). The laboratory changes associated with the treatment with azithromycin were not clinically significant. The majority of adverse events reported were related to the gastrointestinal and central nervous systems, and were classified as mild or moderate. Only two patients had to be withdrawn from the study due to adverse events.. Three monthly pulses of azithromycin 500 mg for 3 consecutive days is safe, well tolerated, effective and promotes increased patient adhesion to the treatment.

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Azithromycin; Cohort Studies; Female; Humans; Male; Pulse Therapy, Drug; Severity of Illness Index; Treatment Outcome; Young Adult

This open, multicenter, comparative, randomized study included 120 subjects with papulopustular stage of acne vulgaris. Subjects were randomized to one of the three treatment groups (A, total dose 4.5 g of azithromycin in 7 weeks; B, total dose 6.0 g in 10 weeks; and C, total dose 7.5 g in 13 weeks). The aim was to identify the optimum azithromycin dose in the treatment of acne vulgaris through monitoring the efficacy and safety of three dosage regimens. Clinical efficacy was assessed upon completion of study therapy and six months of therapy initiation. Post-therapeutic efficacy assessment was available in 104 subjects. The difference between three treatment groups was most pronounced in the "cure" category (36.11% in group A, 58.82% in group B and 55.88% in group C) and "failure" category (8.33% in group A, and no failures in groups B and C). Follow up efficacy assessment was available in 87 subjects. The group percentage of "cure" was lower and group percentage of "treatment failure" higher in group A than in groups B and C. Azithromycin in a total dose of 6.0 g in 10 weeks seems to be a promising agent in the treatment of papulopustular acne vulgaris with few side effects and good patient compliance.

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Dose-Response Relationship, Drug; Female; Humans; Male; Treatment Outcome

To study the efficacy, safety, and compliance of 500 mg azithromycin thrice weekly for 8 weeks to treat acne vulgaris in adolescents.. An open-label, non-comparative study was carried out for 8 weeks. Fifty-two teenagers with moderate to severe papulo-pustular acne vulgaris were enrolled. Azithromycin, 500 mg orally thrice weekly for 8 weeks, was prescribed. No topical treatment was permitted. At the baseline visit, patients were scheduled to return at two-weekly intervals for 8 weeks. Efficacy was gauged by the percentage clearance of papulo-pustular acne lesions. All patients were also evaluated at four months post-treatment.. A majority of patients (47/52) showed remarkable improvement in the first 4 weeks with a more than 20 percent reduction of their inflammatory papulo-pustular lesions. Maximum clearance was observed in 32 patients at 8 weeks. Slow improvement with eruptions of new lesions was seen in 6 patients. Adverse events, such as heartburn and nausea, were reported by 3 patients. All patients completed the 8-week study period. The beneficial effect was maintained at 4 months after the conclusion of treatment.. Azithromycin, 500 mg thrice weekly for 8 weeks, appears to be a safe and effective treatment for acne vulgaris in adolescents, with excellent patient compliance.

Topics: Acne Vulgaris; Adult; Aged; Anti-Bacterial Agents; Azithromycin; Female; Humans; Male; Middle Aged; Treatment Outcome

Acne vulgaris affects a large number of young adults and often presents with facial and truncal involvement. Systemic antibiotics are used for the treatment of papulopustular and cystic lesions.. We sought to determine the efficacy and safety of azithromycin versus tetracycline in the treatment of acne vulgaris.. A randomized, investigator-blind, clinical trial was carried out for 3 months at the outpatient clinic of Emam Khomeini University Hospital, Ahwaz, Iran. A total of 290 patients with moderate to severe papulopustular acne vulgaris were allocated to two groups, azithromycin and tetracycline, for 3 months of treatment. Azithromycin 500 mg was prescribed for 3 consecutive days a week for 1 month and then 250 mg every other day for the following 2 months. Tetracycline 1 g was similarly prescribed: daily for 1 month and then 500 mg daily for the following 2 months.. Both antibiotics were effective in reducing inflammatory lesions and improving acne. Azithromycin produced a slightly higher percentage of improvement compared with tetracycline (100 cases/84.7% vs 94 cases/79.7%).. Azithromycin is a safe and effective alternative in the treatment of inflammatory acne.

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Child; Female; Humans; Male; Single-Blind Method; Tetracycline; Treatment Outcome

Acne vulgaris is a common inflammatory disorder of the skin. Oral antibiotics are known to be effective in its treatment. A randomized, investigator-blinded study was performed to compare the efficacy of azithromycin with doxycycline. Fifty-one patients were randomized to receive either azithromycin 500 mg/day on 3 consecutive days per week in the first, on 2 consecutive days per week in the second, and on 1 day per week in the third month. The other group was given doxycycline twice a day for the first month and once a day for the second and third months. Clinical assessment was made at baseline, at the end of first, second, third, and post-treatment first and second months. Side effects were recorded. Statistically significant improvement for the facial lesions were obtained with both drugs. Neither drug was shown to be more effective than the other. The beneficial effect continued until 2 months after treatment. In the azithromycin group three patients had diarrohea, while photosensitivity was seen in two patients using doxycycline. This study indicates that azithromycin is at least as effective as doxycycline in the treatment of acne.

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Doxycycline; Drug Administration Schedule; Female; Humans; Male; Single-Blind Method; Treatment Outcome

Erythromycin is a common therapy for acne and rosacea. A newer macrolide, azithromycin, offers superior tissue distribution and cellular concentration and is an effective oral anti-acne agent. Topical formulations such as erythromycin have been a major clinical therapy for acne. To date, no topical solution of azithromycin is available for the treatment of acne.. To prepare a stable topical 2% azithromycin formulation that could be used in an acne clinical trial to determine the efficacy of topical azithromycin in treating subjects with acne vulgaris and acne rosacea.. The study was divided into two phases. In phase I, azithromycin was prepared over a range of ethanol/water concentrations to determine solubility. The stability of a 2% azithromycin in 60% ethanol/water preparation was assessed by high-pressure liquid chromatography. The temperature, light, and pH dependence of the stability was also assessed. In phase II, a single center, randomized, double-blind, treatment-controlled study compared once-nightly application of topical 2% azithromycin versus 2% erythromycin. A total of 20 subjects with moderate inflammatory acne and 20 with rosacea were examined clinically at 0, 2, 4, 8, and 12 weeks for a 12-week period. Efficacy was evaluated with the Physician's Visual Analog Scale evaluation (PVAS), the papulopustule count, and acne severity rating (in subjects with acne).. In phase I, azithromycin was soluble in 60% ethanol/water. A 2% azithromycin in 60% ethanol/water solution maintained stability at room temperature for up to 26 weeks but at 37 degrees C there was some decay (16%) at 26 weeks. The stability was greatest at pH 6.8 and was unaffected by ambient light exposure. In phase II, the number of inflammatory lesions decreased in both acne and rosacea subjects treated with 2% erythromycin (7.56, p=0.03 and 4.4, p=0.01, respectively). Azithromycin was not as effective for the treatment of rosacea. Both azithromycin (p=0.01) and erythromycin (p=0.03) treatment significantly reduced the inflammatory lesion count in acne vulgaris. No significant adverse events were identified in the acne group. In patients with rosacea, transient irritation occurred in five patients.. A 2% azithromycin in 60% ethanol/water solution can be prepared and is stable for at least 6 months at room temperature. The methodology and power of the study were adequate to identify improvement in acne vulgaris and rosacea. Though it appears the formulation of topical azithromycin was at least comparable with topical erythromycin, larger studies would be needed to determine whether topical azithromycin has any significant advantage over topical erythromycin.

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Chemistry, Pharmaceutical; Child; Double-Blind Method; Drug Stability; Erythromycin; Female; Humans; Male; Rosacea; Solutions

To study the efficacy, safety, and compliance of 500 mg azithromycin thrice weekly for 12 weeks in acne vulgaris.. An open-label, noncomparative study was carried out for 12 weeks at the outpatient clinics of Aga Khan University Hospital, Abassi Shaheed Hospital, and Burhani Community Hospital in Karachi, Pakistan. Thirty-five adolescent and postadolescent patients with moderate to severe papulopustular acne vulgaris were enrolled. All patients completed the study. Azithromycin, 500 mg orally thrice weekly for 12 weeks, was used. After the baseline visit, patients were scheduled to return at four-weekly intervals for 12 weeks. Efficacy was gauged by the percentage clearance of papulopustular acne lesions. Safety assessments included the monitoring of adverse events, and compliance was checked at the four-weekly regular visits up to 12 weeks.. Twenty-nine patients (82.9%) showed remarkable improvement in the first 4 weeks with 60% reduction of their inflammatory papulopustular lesions. Maximum clearance (80%) was observed at 12 weeks. Residual postinflammatory pigmentation and pitted and linear scarring represented the aftermath of the relapsing pattern of acne. Six patients (17.1%) showed slow clearance with eruptions of new lesions. Adverse events, such as heartburn and nausea, were reported by four patients (11.4%). All patients completed the 12-week study period.. Azithromycin, 500 mg thrice weekly for 12 weeks, is a safe and effective treatment of acne vulgaris with excellent patient compliance.

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Adult; Azithromycin; Female; Humans; Male; Pakistan; Severity of Illness Index; Treatment Outcome

Acne vulgaris is a common skin disease seen primarily in adolescent 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. To evaluate the role of a monthly dose of azithromycin and compare it with daily doxycycline, we conducted this randomized comparative study. Sixty patients with moderate to severe acne were randomly assigned to two treatment groups, A & B. Patients in group A received 100 mg doxycycline daily in addition to topical 0.05% tretinoin cream, whereas patients in group B were given 500 mg azithromycin once a day for four days per month along with 0.05% topical tretinoin for a total of 12 weeks. Of the 60 patients, 22 in group A and 28 in group B were evaluated. The monthly dose of azithromycin was found to be as effective as daily doxycycline on a pure protocol basis and statistically significantly better than doxycycline by intention to treat analysis.

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Doxycycline; Drug Administration Schedule; Female; Humans; Male; Pulse Therapy, Drug; Treatment Outcome

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Child; Female; Humans; Male; Middle Aged; Rosacea

This open study was conducted in 72 outpatients with acne vulgaris, to compare the clinical efficacy and tolerability of azithromycin and minocycline. Azithromycin was administered as a single oral dose (500 mg/day) for 4 days in four cycles every 10 days and minocycline was administered 100 mg daily for 6 weeks. Improvement was assessed 6 weeks after initiation of treatment with a four-graded scale. A satisfactory clinical response was observed in 75.8% of the patients treated with azithromycin and in 70.5% of those treated with minocycline. There were no significant differences between these two acne treatments in terms of reduction of the number of lesions (p> 0.05). Both agents were well tolerated and mild side effects were reported in 10.3% of azithromycin and 11.7% of minocycline treated patients. We conclude that azithromycin is at least as clinically effective and well tolerated as minocycline as treatment of facial comedonic and papulopustular acne.

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Female; Humans; Male; Minocycline; Treatment Outcome

To measure the efficacy of oral probiotics when combined with a topical agent, and to compare the efficacy of Azithromycin, Probiotics, and their combination for the treatment of acne vulgaris.. A quasi-experimental study. Place and Duration of the Study: Pharmacology Department, IIMC in mutual collaboration with the Dermatology Department, Pak Emirates Military Hospital (PEMH), Rawalpindi, from September 2021 to August 2022.. Seventy-five patients were enrolled in the study and were divided into 3 groups. Group A received Azithromycin (250mg oral on alternate days), Group B received probiotics i.e. Hi-Flora sachet (1 sachet oral daily), and Group C received both azithromycin (250mg oral on alternate days) and probiotics (Hi-Flora 1 sachet oral daily). The efficacy of three treatment regimens was measured by checking the difference in mean lesion count at the baseline and after 3 months of treatment and the percentage was calculated.. All patients demonstrated significant improvement in total lesion count after treatment. In group A, the mean lesion count was reduced by 83.3%, in group B by 84.4%, and in group C, the reduction in mean lesion count was 90.3%.. Probiotics have equal efficacy to azithromycin, and their combination has shown synergistic effects for the treatment of acne vulgaris. Probiotics should be used in combination with azithromycin for the best results for the management of acne vulgaris.. Acne vulgaris, Azithromycin, Probiotics, Efficacy.

Topics: Acne Vulgaris; Administration, Oral; Anti-Bacterial Agents; Azithromycin; Humans; Treatment Outcome

BACKGROUND Clostridium difficile (C. difficile) is a gram-positive, anaerobic, spore-forming bacillus. It can lead to pseudomembranous colitis characterized by electrolyte disturbances, toxic megacolon, and septic shock. The risk of C. difficile infection is higher with use of certain classes of antibiotics, or when an antibiotic used for a long time. Azithromycin is a macrolide antibiotic known to be safe, with few adverse effects such as diarrhea, stomach pain, and constipation. Azithromycin is currently used for the treatment of acne, with different dosing regimens for patients who cannot receive traditional treatment based on practice guidelines. CASE REPORT A 41-year-old woman was treated with a course of azithromycin 500 mg by mouth 3 times weekly for 6 weeks for acne vulgaris. This was her second antibiotic course of acne treatment within 10 months. A few days after completion of the second azithromycin course, she presented to the clinic with worsening abdominal pain and frequent soft bloody stool. A complete blood count test, C. difficile toxin test, stool culture, and colonoscopy were ordered. She was diagnosed with C. difficile infection confirmed by C. difficile toxin and symptoms. CONCLUSIONS Despite the safety profile of azithromycin, our patient was predisposed to a non-severe case of C. difficile-associated diarrhea, most likely due to the repeated course of the azithromycin regimen that was used to treat her acne vulgaris. This report highlights the importance of managing patients with acne vulgaris according to current practice guidelines, and to report a link between the use of azithromycin as an acne treatment and the occurrence of C. difficile colitis.

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Azithromycin; Clostridioides difficile; Clostridium Infections; Diarrhea; Enterocolitis, Pseudomembranous; Female; Humans

Topics: Acne Vulgaris; Anti-Bacterial Agents; Azithromycin; Drug Resistance, Microbial; Humans

Topics: Acne Vulgaris; Acute Generalized Exanthematous Pustulosis; Adult; Azathioprine; Azithromycin; Clobetasol; Crohn Disease; Drug Substitution; Female; Gastrointestinal Agents; Glucocorticoids; Humans; Infliximab; Remission Induction; Skin; Treatment Outcome

The objectives of the current investigation are (1) to prepare and characterize (particle size, surface charge (potential zeta), surface morphology by transmission electron microscopy, drug content, and drug release) the azithromycin (AZM, 100 mg)-loaded oil-in-water (o/w) macroemulsion, (2) to assess the toxicity of macroemulsion with or without AZM using RBC lysis test in comparison with AZM in phosphate buffer solution of pH 7.4, (3) to compare the in vitro antimicrobial activity (in Escherichia coli using zone inhibition assay) of AZM-loaded macroemulsion with its aqueous solution, and (4) to assess the in vitro anti-inflammatory effect (using egg albumin denaturation bioassay) of the AZM-loaded macroemulsion in comparison with diclofenac sodium in phosphate buffer solution of pH 7.4. The AZM-loaded macroemulsion possessed the dispersed oil droplets with a mean diameter value of 52.40 ± 1.55 μm. A reversal in the zeta potential value from negative (-2.16 ± 0.75 mV) to positive (+6.52 ± 0.96 mV) was noticed when AZM was added into the macroemulsion. At a 1:5 dilution ratio, 2.06 ± 0.03 mg of drug was released from macroemulsion followed by 1.01 ± 0.01 and 0.25 ± 0.08 mg, respectively, for 1:10 and 1:40 dilution ratios. Antimicrobial activity maintenance and significant reduction of RBC lysis property were noticed for AZM after loaded in the macroemulsion. However, an increment in the absorbance values for emulsion-treated samples in comparison to the control samples was noticed in the anti-inflammatory test. This speculates the potential of the AZM-loaded emulsion to manage inflammatory conditions produced at Acne vulgaris.

Topics: Acne Vulgaris; Anti-Bacterial Agents; Anti-Inflammatory Agents; Azithromycin; Chitosan; Disease Management; Emulsions; Humans; Polysorbates; Water

The aim of the study was to investigate the efficacy, safety and compliance of 500 mg azithromycin thrice weekly for 12 weeks in moderate inflammatory acne vulgaris. An open-label, noncomparative study was carried out for 12 weeks at Department of Dermatology and Plastic Surgery, La Sapienza University in Rome. Fifty-seven patients (20 male and 37 female) between 13 and 41 years of age, affected by moderate papulopustular and nodular acne vulgaris, were enrolled in the study. Azithromycin 500 mg was administered orally thrice weekly for 12 weeks. Patients were examined at baseline, 4 weeks, 8 weeks and 12 weeks (completion of treatment), evaluating both clinical (Global Acne Grading System, GAGS) and quality of life (Acne Quality of Life Questionnaire, AQoL) improvements. Forty-six patients completed the study and showed significant improvement. Six patients interrupted their treatment, while five patients did not complete the study for unknown reasons. Side effects (diarrhea and abdominal pain) were recorded in eight patients. Azithromycin, 500 mg thrice weekly for 12 weeks, is a safe and effective treatment for moderate acne vulgaris with excellent patient compliance.

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Adult; Analysis of Variance; Anti-Bacterial Agents; Azithromycin; Female; Humans; Male; Patient Compliance; Quality of Life; Statistics, Nonparametric; Surveys and Questionnaires; Treatment Outcome

Topics: Acne Vulgaris; Anti-Bacterial Agents; Azithromycin; Clinical Trials as Topic; Humans; Remission Induction

Acne affects a large number of young adults, including women, who often present with facial as well as truncal involvement. Systemic antimicrobial agents currently used for the reduction of inflammatory papules and cysts require frequent administration and are sometimes associated with uncomfortable side-effects contributing to a decrease in compliance.. Ninety-nine episodes of inflammatory acne in 79 patients treated with oral antimicrobial agents were studied retrospectively over a period of 46 weeks. Patients were treated with tetracycline, erythromycin, minocycline, and doxycycline, the most commonly prescribed oral antimicrobials used to treat acne. Individuals that were unable to tolerate this therapy or had failed conventional therapy were treated with the azalide antibiotic azithromycin, given in a single oral 250-mg dose three times a week. The other agents were administered daily in divided doses as is current practice. Patients were also on topical care.. The efficacy and reported side-effects were examined for all agents. Significant improvement was noted in 4 weeks. All agents were effective in reducing inflammatory lesions and improving acne. Azithromycin produced a slightly higher percentage of patients with a greater than 80% reduction in their inflammatory acne lesions (85.7%) vs. an average of 77.1% for all other agents. All differences observed were not statistically significant.. The results show that azithromycin is a safe and effective alternative in the treatment of inflammatory acne with few side-effects and good compliance, and suggest the need for further investigation with a clinical trial that will compare the long-term efficacy and tolerability.

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Retrospective Studies; Treatment Outcome

Topics: Acne Vulgaris; Anti-Bacterial Agents; Azithromycin; Humans; Rosacea

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Azithromycin; Female; Humans