Azithromycin for Acne in Adolescents

Acne vulgaris is a common inflammatory disorder of the pilo-sebaceous follicles. It is a multifactorial disease and its pathophysiology centers on the interplay of follicular hyperkeratinization, colonization with Propionibacterium acnes (PA), increased sebum production, and inflammation. This disease is occurring mainly in adolescence. Although the peak of prevalence is around the 17th year of life, acne lesions can appear earlier and are not uncommonly observed in the age group ranging from 12 to 14 years.

Antibiotic therapy has long been found useful in the management of moderate-to-severe acne vulgaris. Mechanisms of action include suppressing growth of PA, reducing the production of inflammatory mediators, and acting in immunomodulation. Commonly prescribed antibiotics include tetracyclines, doxycycline, minocycline and erythromycin.

Based on an article published in March edition of Medscape Journal:
Recent research, by Federico Bardazzi et all at university of Bologna, Italy, has been carried out to demonstrate the role of azithromycin in acne treatment and its efficacy.
An open-label, non-comparative study was carried out for 8 weeks 52 teenagers with moderate to severe papulo-pustular acne vulgaris. Azithromycin 500mg orally thrice weekly for 8 weeks was prescribed but no topical treatment was permitted during their study. A majority of patients (47/52) showed remarkable improvement in the first 4 weeks with a more than 20 % reduction of their inflammatory papulo-pustular lesions.
All patients completed the 8- week study period. The beneficial effect was maintained at 4 months after the conclusion of treatment. This study concluded that, Azythromycin 500 mg thrice weekly for 8 weeks appears to be a safe and effective treatment for acne vulgaris in adolescents, with excellent patient compliance.