Kim Jung Eun, Park A Young, Lee Sung Yul, Park Young Lip, Whang Kyu Uang, Kim Hyun-Jung
Department of Dermatology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Department of Dermatology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
Ann Dermatol. 2018 Aug;30(4):417-426. doi: 10.5021/ad.2018.30.4.417. Epub 2018 Jun 28.
Acne vulgaris is one of the most common disorders of the pilosebaceous unit. Although doxycycline is considered to be a first-line anti-acne antibiotic, various other antibiotics have been tried due to its adverse effects and contraindications. We performed a meta-analysis of randomized controlled trials (RCTs) that compared the efficacy of oral azithromycin pulse therapy with that of oral daily doxycycline in the management of moderate to severe acne vulgaris.
Five scientific databases (MEDLINE, EMBASE, Cochrane Library, SCOPUS, and Web of Science) were searched to identify relevant studies. A review of 1,341 publications produced six RCTs that met our predefined inclusion criteria. The clinical outcome measures were remaining acne lesion counts, patients' self-assessment of treatment, and the investigators' assessment of treatment after 12 weeks.
We included six studies assessing 906 patients with moderate to severe acne vulgaris. Meta-analyses of clinical outcome measures revealed no significant difference between the two groups regarding remaining acne lesion counts (=0.27), patients' self-assessment of treatment (=0.67), and the investigators' assessment of treatment (=0.32). The incidence of severe adverse events leading to the discontinuation of therapy was higher in the doxycycline daily therapy group when compared with the azithromycin pulse therapy group.
This study indicates that azithromycin pulse therapy is equivalent to doxycycline at 12 weeks in the efficacy of the treatment for moderate to severe acne vulgaris Therefore, oral azithromycin pulse therapy may be a good alternative to doxycycline in the management of acne for those unable to tolerate doxycycline.
寻常痤疮是皮脂腺单位最常见的疾病之一。尽管多西环素被认为是一线抗痤疮抗生素，但由于其不良反应和禁忌证，人们尝试了各种其他抗生素。我们对随机对照试验（RCT）进行了荟萃分析，比较口服阿奇霉素脉冲疗法与口服每日多西环素治疗中度至重度寻常痤疮的疗效。
检索了五个科学数据库（MEDLINE、EMBASE、Cochrane图书馆、SCOPUS和Web of Science）以确定相关研究。对1341篇出版物的综述产生了六项符合我们预先定义纳入标准的RCT。临床结局指标为12周后剩余痤疮皮损计数、患者对治疗的自我评估以及研究者对治疗的评估。
我们纳入了六项评估906例中度至重度寻常痤疮患者的研究。对临床结局指标的荟萃分析显示，两组在剩余痤疮皮损计数（=0.27）、患者对治疗的自我评估（=0.67）和研究者对治疗的评估（=0.32）方面无显著差异。与阿奇霉素脉冲疗法组相比，多西环素每日治疗组导致治疗中断的严重不良事件发生率更高。
本研究表明，阿奇霉素脉冲疗法在治疗中度至重度寻常痤疮的疗效上与12周的多西环素相当。因此，对于无法耐受多西环素的痤疮患者，口服阿奇霉素脉冲疗法可能是一种很好的替代疗法。
