acne vulgaris: treatment with azithromycin kouzeva v, hitova m, dancheva a, kaliasheva p city center...
TRANSCRIPT
Acne Vulgaris:Treatment with Azithromycin
Kouzeva V, Hitova M, Dancheva A, Kaliasheva P
City Center for Dermatovenerology, Sofia
Bulgaria
INTRODUCTION I Acne Vulgaris is multifactor disease and there are lot of
target places for therapeutic alleviation. The typical pathogenesis development of the disease is abnormal follicular keratinisation of the pilosebaceic unit, followed by sebum accumulation, which leads to the first lesions in acne: comedons. The colonization of Propionbacterium acnes in the comedons and the the followed inflammation , leads to lesions of which papules and pustules are features of the moderate acne papulopustulosis.
.
INTRODUCTION IIAcne is not infectious disease, but the antibiotics have a major
place in the therapeutic approaches of the treatment. Mechanisms of action of antibiotics against Acne are two:
• Reduction of the quantity of P.acnes and subsequent change of the ratio between free lipid acids compared to superficial lipids;
• Reduction of the free lipid acids trough inhibition of the bacterial lipases.
The antibiotics used for the treatment of acne are requiring frequently dosing and are related to unwanted side effects.
METHODS I1.PATIENT CHARACTERISTICS:
Number Percent of total
Patients Nr. 150 100.00%
Male 99 66.67%
Female 51 33.33%
Age 12 –25
2.Treatment and dosing regimen: 3 times weekly -250mg of Azythromycin for 10 weeks.
Moderate to severe acne papulopustulosis, with number of the lesions varying from 10 to 50, spread in the face, back and neck.
Patients should not be treated with antibiotics for acne therapy for the last 4 weeks.
Patients should not be treated with hormonal preparations for acne therapy for the last 3 months.
Patients should not be treated with topical anti-acne therapy for the last 4 weeks.
METHODS II3. Inclusion criteria:
METHODS III4. Distribution of the patients, depending on the severity of Acne:
Number of papulopustulosis
Patients number
Percent of the total
10 - 20 22 14.81%
20 – 30 61 40.74%
30 – 40 55 37.00%
40 – 50 12 7.40%
METHODS IV5. Visits during the 24 weeks observation period:
Visit 1 – Initial visit for the start of the therapyVisit 2 - on week 3Visit 3 - on week 10Visit 4 - on week 24
During the course of the treatment patients used topical non-comedonogenic dermatocosmetics.
Reduction of the number of the lesions in the face,back and neck.
Patients subjective assessment for the therapeutic alleviation of acne.
METHODS V6. Criteria for evaluation of the treatment efficacy:
RESULTS I
Patients number Percent
Reduction of the number of the lesions
150 100%
Reduction over 80% male
78 51.85%
Reduction over 80% female
38 25.92%
Reduction over 80%
TOTAL
116 77.78%
Reduction below 25%
male
23 14.80%
Reduction below 25%
female
11 7.40%
Reduction below 25%
TOTAL
34 22.22%
Evaluation on week 3 by Investigator
RESULTS II
Patients number Percent
Evaluation by the patients
150 100%
Full treatment success
78 51.85%
Very good improvement
38 25.92%
Satisfactory improvement
34 22.22%
Lack of improvement 0 0%
Deterioration 0 0%
Evaluation on week 3 by Patients
RESULTS III
Patients number
Percent
Reduction of the number of the lesions
150 100%
Reduction over 80%
TOTAL
133 88.89%
Reduction below 25%
TOTAL
17 11.11%
Evaluation on week 10 by Investigator
RESULTS IV
Patients number Percent
Evaluation by the patients
150 100%
Full treatment success
110 74.10%
Very good improvement
34 22.22%
Satisfactory improvement
6 3.7%
Lack of improvement 0 0%
Deterioration 0 0%
Evaluation on week 10 by Patients
RESULTS V
Patients number
Percent
Reduction of the number of the lesions
150 100%
Reduction over 80%
TOTAL
121 81.48%
Reduction below 25%
TOTAL
29 18.52%
Evaluation on week 24 by Investigator
RESULTS VI
Patients number Percent
Evaluation by the patients
150 100%
Full treatment success
110 74.10%
Very good improvement
11 7.41%
Satisfactory improvement
17 11.11%
Lack of improvement 6 3.7%
Deterioration 6 3.7%
Evaluation on week 24 by Patients
RESULTS VII
DURING 10 WEEKS OF TREATMENT WERE NOT OBSERVED UNWANTED
SIDE EFFECTS RELATED TO AZITHROMYCIN
The results drawn by the study are showing the high
efficacy of azithromycin in the treatment of Acne
papulopustulosis.
Azithromycin is safe and well tolerated in real clinical
settings.
Azithromycin is convenient for application –
1capsule of 250mg, 3 times a week for 10 weeks.
CONCLUSIONS