Comparison of efficacy of Azithromycin vs. Clindamycin and Erythromycin in the treatment of mild to moderate acne vulgaris

Objective: Acne vulgaris is a prevalent inflammatory skin disorder. Topical solutions of clindamycin and erythromycin are the most common treatment in the patients. This study was conducted to compare the effect of topical solution azithromycin as a new method of treatment against topical solutions of clindamycin and erythromycin. Methodology: A randomized double-blind clinical trial was carried out for 20 weeks at the outpatient clinics of Boo-Ali Sina Hospital in Sari (Iran) on 96 patients with mild to moderate acne vulgaris. They were randomly divided in three groups who were matched together based on Acne Severity Index(ASI) and were treated with 2% alcoholic solution of azithromycin, erythromycin and clindamycin respectively twice daily for 16 weeks. Treatment efficacy was determined by Total acne Lesion Counting (TLC). Results: For each three treatment groups, decreased TLC and ASI were significant at the end of 16 weeks (P < 0.05). Azithromycin was more effective than the clindamycin and erythromycin for acne therapy after 16 weeks (P < 0.05). Twenty patients (20.8%) of azithromycin group (12.5%) reported to have adverse effects, such as erythema and/or pruritus (P < 0.05). Conclusion: Topical solution azithromycin is a more effective treatment for mild to moderate acne vulgaris comparing to clindamycin and erythromycin, but it has more local side effects.