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A comparison of cost-effectiveness between doxycycline and azithromycin with topical clindamycin in the treatment of patients with moderate to severe acne vulgaris: Prospective, randomized study

Apoorva, Girish K, Amoolya D.

Background: Acne vulgaris is one of the chronic, common dermatological skin diseases with inflammatory lesions, prevalent among adolescents. The management of acne vulgaris is primarily pharmacotherapy comprising both topical and systemic anti-inflammatory and antimicrobials agents.

Aims and Objective: Pharmacoeconomic analysis is now an integral part of therapy. There are several studies regarding recommendations, guidelines, efficacy, tolerability, and outcomes of therapies used in acne vulgaris; but hardly any studies comparing the cost-effectiveness of this combination of topical and oral antimicrobials in the treatment of moderate to severe acne vulgaris in our country; hence, this study was taken up to provide useful and valid data.

Materials and Methods: This was a randomized, open-label, active-controlled, comparative study of cost-effectiveness analysis of doxycycline and azithromycin in 60 subjects, who gave written informed consent and had moderate to severe acne vulgaris. Azithromycin was given as pulse therapy whereas doxycycline was given once daily with topical clindamycin twice daily for 8 weeks in both groups. Direct and indirect medical costs were considered, average cost-effectiveness ratio (ACER) and cost-effective analysis (CEA) were analyzed. Non-parametric test like Mann–Whitney test was used to access the efficacy of the drugs and the result was statistically significant. Results were depicted in the form of tables, figures, and graphs.

Results: The ACER and CEA showed that azithromycin was better than doxycycline.

Conclusion: The study drugs were effective in reducing the lesion count but required long-term treatment; however, azithromycin was more cost-effective than doxycycline.

Key words: Acne Vulgaris; Azithromycin; Cost-effective Analysis; Doxycycline

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The articles in Bibliomed are open access articles licensed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (https://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.