Combination of azelaic acid 5% and erythromycin 2% in the treatment of acne vulgaris.
BACKGROUND
Acne vulgaris is a common problem, particularly among adolescents, which is usually resistant to monotherapy. We evaluated the efficacy and safety of a combination of azelaic acid (AA) 5% and erythromycin 2% gel (AzE) compared with AA 20% or erythromycin 2% gels in facial acne vulgaris.


METHODS
We conducted a 12-week, multicenter, randomized double-blind study on 147 patients with mild-to-moderate acne vulgaris. Four treatment group were determined (placebo, erythromycin, AA and AzE) and followed in 4-week intervals for 12 weeks, except the placebo group which was changed to routine treatment after 4 weeks.


RESULTS
The combination of AA 5% and erythromycin 2% gel significantly reduced the number of papules, pustules and comedones compared with placebo (p < 0.001), erythromycin 2% (p < 0.01) or AA 20% (p < 0.05). The incidence of adverse effects observed in patients treated with AzE (27%) was less than that with erythromycin 2% (54%) and AA 20% (45%).


CONCLUSIONS
The combination of AA 5% and erythromycin 2% produced more potent therapeutic effects in comparison with erythromycin 2% or AA 20% alone, and with fewer side effects.
Pazoki-Toroudi
Hamidreza
H
Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran.
Nassiri-Kashani
Mansour
M
Tabatabaie
Hossein
H
Ajami
Marjan
M
Habibey
Rouhollah
R
Shizarpour
Mohammad
M
Babakoohi
Shahab
S
Rahshenas
Makan
M
Firooz
Alireza
A
D000152:Acne Vulgaris / Q000175:diagnosis* / Q000188:drug therapy*; D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000494:pharmacology / Q000627:therapeutic use; D003998:Dicarboxylic Acids / Q000494:pharmacology / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004917:Erythromycin / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult
D000900:Anti-Bacterial Agents; D003879:Dermatologic Agents; D003998:Dicarboxylic Acids; D004917:Erythromycin; C010038:azelaic acid