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Therapeutic study of rosacea by Azithromycin and Metronidazole

Author: Naseer A. Al-harchan* MBChB, MSc, PhD د. نصير عبد الامير الحرجان
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2009 Volume: 51 Issue: 4 Pages: 429-432
Publisher: Baghdad University جامعة بغداد

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Abstract

Summery:Background: Rosacea is a chronic disease that requires long-term systemic and or local therapy, which carries risk for systemic complications and adverse reactions and high recurrence rate. Patient and methods: Two groups of rosacea patient with at least 8 inflammatory papules and pustules, moderate to severe facial erythema (22 patient treated with oral azithromycin versus 18 patient treated with oral metronidazole) were studied at single medical center (medical city of Baghdad: department of dermatology and venereology , both for 60 days, Subjects were evaluated monthly for up to three months to determine the relapse rate. Main outcome measures: Inflammatory papules and pustules were counted at each visit, relapse were determined by the appearance of a clinically significant increase in number of papules and pustules. Erythema were classified to three grades: - 0=Nil, 1=mild to moderate, 2=severe. Patient satisfaction also classified to three grades: 0=no satisfaction, 1=partial satisfaction, 2=full satisfaction.Results: Most of the patients respond to treatment measured by at least 70% reduction in the number of inflammatory lesions. (21 patient versus 14 patient) completed the study and compare by assessing:- erythema improvement and papule and pustule count reduction and percentage of occurrence of side effects and relapse, and subjective assessment of the degree of patients satisfaction with their treatment Erythema were reduced after two months of treatment:- (56.6% to 33.3% for azithromycin group versus 43.5% to 66.7% for metronidazole group).Mean papules count reduced from (36.9 to 10 for azithromycin group versus 25.8 to 11 for metronidazole group). Mean pustule count reduced from (2.95 to 0.33 for azithromycin group versus 2.92 to 0.5 for metronidazole group). The percentage of relapse was 16.7% versus 83.3% for azithromycin and metronidazole group respectively. Complete satisfactions were 70% versus 30% and side effect were 20% versus 80% for azithromycin and metronidazole group respectively. Conclusion: For the above results treatment of rosacea by azithromycin is more effective, safer thanmetronidazole, although the coast is little higher.Key Words: Azithromycin , Rosacea .

Keywords

Azithromycin --- Rosacea


Article
Beneficial Effect of Isotretinoin Gel As AdjunctiveTreatment to Oral Azithromycin in the Management of Facial Acne Vulgaris.

Author: Sabeeh A. Al-Mashhadani
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 1 Pages: 7-10
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Acne is a multifactorial disease with multiple pathogenic factors, hence combination therapies are needed. Combination therapies using agents with complementary mechanisms of action increasingly are recognized as an effective strategy for treating acne.OBJECTIVE:The rationale of utilizing topical retinoids with azithromycin in treating facial acne vulgaris will be highlighted, particularly in relation to improvement.METHODS:A randomized, clinical trial was carried out at the outpatient Department of Dermatology and Venereology, Baghdad Teaching Hospital between April 2007 and August 2008.A total of 48 patients with moderate to severe papulopustular acne vulgaris were allocated to two groups, azithromycin and azithromycin plus isotretinoin gel, both groups received Azithromycin for two months. Azithromycin 250 mg was prescribed every day for one month and every other day for the following month. Patients in second group were instructed to apply Isotretinoin gel 0.05% once daily over a 3 months treatment period. The clinical assessment was done by counting the number of inflammatory lesions in three occasions: baseline, two months and three months.RESULT:After two months, both groups showed a statistically significant difference from the baseline in reducing inflammatory lesions and improving acne. Adding topical isotretinoin gel produced a higher percentage of reduction in their lesional counts, but differences between the two groups were not statistically significant. After three months, regression in the percentage of reduction of the lesional count from 57.7% to 32.4% in the first group. While in the second group the reduction was maintain in 69.8%.CONCLUSION:Adding topical 0.05 per cent isotretinoin gel to oral azithromycin enhances and maintains the rate of improvement of facial acne vulgaris.

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