Comparison of oral azithromycin with oral doxycycline in the treatment of acne vulgaris.

BACKGROUND: Acne vulgaris is a common inflammatory disorder of the skin that involves pilosebaceous units. This study was conducted to compare the efficacy of oral azithromycin with oral doxycycline in the treatment of acne vulgaris in our population. METHODS: This randomized controlled trial was conducted in the dermatology department of Lady Reading Hospital, Peshawar from January to December 2011. All male and female patients of age (14-30 years) having moderate acne vulgaris on face only were included in the study. Patients were randomly divided into two groups. Patients in first group were given azithromycin 500 mg daily before meal for 4 consecutive days monthly for 3 months while patients in second group were given doxycycline 100 mg daily after meals for 3 months. Patients were followed up after taking treatment for three months to see the response of each drug. Response was graded as excellent, good, moderate, mild and no response. RESULTS: A total of 386 patients equally divided in azithromycin and doxycycline groups. Male to female ratio in azithromycin and doxycycline groups was 0.82:1.11 and 0.89:1.04 respectively. Mean age in both groups was 18.45 ± 2.91 years and 17.96 ± 2.59 years respectively. In azithromycin group, an excellent response was noted in 6 (3.1%), and good response was observed in 44 (22.8%) patients. In doxycycline group 22 (11.4%) patients had excellent and 107 (55.4%) patients had good response. The difference being statistically significant. CONCLUSION: Doxycycline is a better option fdr treatment of acne vulgaris as compared to azithromycin.

Methicillin-Resistant Staphylococcus Aureus And Its Antibiotic Sensitivity Pattern In Patients With Vesiculobullous Disorders.

BACKGROUND: Vesiculobullous disorders are among the leading causes of admission to dermatology. These are characterized by distinct mucocutaneous involvement and by the development of vesicles and bullae (i.e. blisters). Methicillin-resistant Staphylococcus aureus (MRSA) is a group of gram-positive bacteria distinct from other strains of Staph aureus. As the susceptibility of bacteria to antibiotics varies from region to region and from time to time, this study will determine the pattern of antimicrobial susceptibility of MRSA isolates to the commonly prescribed antibiotics in our population. The objective is to determine the frequency of methicillin-resistant Staphylococcus aureus and its antibiotic sensitivity pattern in patients with vesiculobullous disorders admitted to the Dermatology unit of Lady Reading Hospital (LRH), Peshawar. It was Cross-sectional and carried out in study Department of Dermatology, Lady Reading Hospital, Peshawar from Oct 23, 2020, to Apr 22, 2021. METHODS: This study was carried out over 132 patients. After consent, Swabs of pus from the Vesiculobullous disorders were taken from all the patients and sent to a laboratory for culture. Staphylococcus aureus (MRSA) was labelled as Staphylococcus aureus bacteria by Kirby-Bauer disc diffusion method using oxacillin (1 µ gm.) disc on Mueller-Hinton agar (HiMedia Labs, Mumbai) with 24 hours incubation at 35 °C. RESULTS: In this study, 132 patients were observed. The average age was 44.44 years ±13.74 SD. Male to female ratio was 1.30:1. There were 44(33.33%) patients who showed Methicillin Resistant Staphylococcus aureus (MRSA) in vesiculobullous disorders patients. CONCLUSIONS: In our population, the frequency of staphylococcus aureus bacteria in vesiculobullous disorders is high so it will be considered while treating such patients.

Comparison Of Efficacy Of Topical Adapalene Plus Oral Azithromycin And Topical Adapalene Plus Oral Doxycycline In Treatment Of Acne Vulgaris.

BACKGROUND: Acne vulgaris is a commonly diagnosed dermatological condition characterised by pilosebaceous unit blockage or inflammation. It may manifest as inflammatory, non-inflammatory, or a combination of the two. The acne vulgaris mostly the face of individual and chest and back of individual is also affected sometime. The aim of my research is to compare the effectiveness of topical adapalene plus oral azithromycin versus topical adapalene plus oral doxycycline in treating acne. Acne is one of most common reason compelling a patient to see dermatological advice. Our goal is to find the most effective antibiotic to produce the best outcomes with the fewest possible unwanted effect (side effects) and a maximum level of patient satisfaction. METHODS: From May 1 to October 31, 2019, a randomised control trial was performed at Dermatology department MTI Lady Reading Hospital Peshawar. Using the lottery form, all of the patients were split into 2 groups. For 12 weeks, patients in Group A were given oral doxycycline 100 mg once daily and topical adapalene, while patients in Group B were given oral azithromycin 250 mg on alternating days and topical adapalene. All patients were followed at the end of 12 weeks after start of therapy to determine the efficacy in term of clearance of at least 60% of the number of lesions from baseline. RESULTS: In Group A, 22 (59.45%) patients expressed positive results whereas in Group B, only 9 (24.32%) patients expressed positive results. p value (0.0021.). CONCLUSIONS: My data suggest that oral doxycycline 100mg in combination with adapalene gave better results as compared to oral azithromycin which was also found well-tolerated option for treatment of acne on face.

Efficacy of Intense Pulse Light Therapy and Tripple Combination Cream Versus Intense Pulse Light Therapy and Tripple Combination Cream Alone in Epidermal Melasma Treatment.

OBJECTIVE: To compare the efficacy of intense pulse light therapy (IPL) and triple combination cream (TCC) versus intense pulse light therapy and triple combination cream alone in epidermal melasma treatment, downgrading MASI score to more than 10. STUDY DESIGN: Randomized controlled trial. PLACE AND DURATION OF STUDY: Dermatology Department, Lady Reading Hospital, Peshawar, from August 2014 to January 2015. METHODOLOGY: Patients of 18-45 years were included in the study with Fitzpatrick skin type II-V. Sample of 96 patients was divided in to three groups of 32 each, through consecutive (non-probability) sampling method. Detailed history was taken, Woods Lamp Examination done, and melasma area and severity index (MASI) score was calculated. TCC had to be applied daily at night for two months by group A patients while group B was consigned for IPL therapy fortnightly, and those in group C were given both for two months. Efficacy was compared by recalculating MASI score at treatment end as well as at follow-up after 4 weeks, using Chi-square test with significance at p < 0.05. RESULTS: Male and female patients were 10 (31.2%) and 22 (68.8%) in group A, 7 (21.9%) and 25 (78.1%) in group B, while in group C were 12 (37.5%) and 20 (62.5%). The average age was 28.70 +8.70 years. MASI score reduction was achieved in 22 (68.8%) patients in group A; whereas, in 20 (62.5%) and 30(93.8%) patients in group B and C, respectively. Efficacy-wise distribution was significant (p=0.009). CONCLUSION: Intense pulse light therapy and triple combination cream are more efficacious in epidermal melasma treatment than intense pulse light therapy and triple combination cream alone.