Combination of Low-Dose Isotretinoin and Pulsed Oral Azithromycin in the Management of Moderate to Severe Acne

In a 2011 study involving 70 patients with moderate to severe acne, a treatment combining low-dose isotretinoin (0.3 mg/kg/day) and pulsed oral azithromycin (500 mg/day for three days every two weeks) was administered. Out of 66 eligible patients, 62 (93.9%) achieved complete clearance of acne after an average of 21 weeks, with a mean total cumulative dose of isotretinoin of 49.6 mg/kg. The relapse rate was 11.3% during the post-treatment follow-up. Adverse effects were generally mild, with three patients experiencing an initial aggravation of acne managed with prednisolone. Despite the promising results, the study's limitations included a small sample size, lack of randomization, and a short follow-up period, indicating that further research with a larger, randomized trial and longer follow-up is necessary to confirm the treatment's safety and efficacy.