Pulse Dosing with Azithromycin

Written by on December 9, 2005 in macrolides with 2 Comments

There doesn’t seem to be many references to what pulse-dosing means with respect to antibiotics. I take this paper to say that triallists were treated with 500mg once a day for 3 days and then took a break for 4 days, repeating the same the following week.

Pulse therapy with azithromycin in acne rosacea and peri-oral dermatitis: an open study.

Azithromycin Appears Effective for Rosacea and Peri-Oral Dermatitis: Presented at AAD

Doctor’s Guide

By Ed Susman, NEW ORLEANS, LA — February 21, 2005 — An eight-week course of antibiotic therapy with azithromycin appears to substantially clear outbreaks of acne rosacea and peri-oral dermatitis, Italian researchers reported on February 20th at the 63rd annual meeting of the American Academy of Dermatology.

“We need something new for our patients with these conditions,” said Ruggero Caputo, MD, chairman of the department of dermatology at the University of Milan, Italy, in discussing his poster at a moderated presentation session.

Dr. Caputo and colleagues recruited 20 men and women with acne rosacea and 20 women with peri-oral dermatitis and treated them with a course of oral azithromycin 500 mg a day for three days. They repeated the “pulse therapy” for at least four weeks and up to eight weeks.

“All the patients improved,” said Dr. Caputo, but marked improvement according to standard scales of improvement ; was observed in 13 patients with papulopustular rosacea after four weeks. After 6 weeks, 15 of the patients had achieved a marked improvement, and that increased to 18 patients, 90% of the group after 8 weeks of treatment.

A similar improvement was seen in the women with peri-oral dermatitis. A marked improvement was demonstrated in 12 patients after 4 weeks, in 14 patients after 6 weeks, and in 17 patients, 85% of the total after 8 weeks.

“Data at the end of the study are suggestive for a clear therapeutic role of azithromycin in papulopustular rosacea and peri-oral dermatitis like [that already] demonstrated in papulopustular acne,” Dr. Caputo said.

He said the trial also shows:

  • Azithromycin has anti-inflammatory properties that could be useful in the treatment of inflammatory dermatoses of the face.
  • Pulse therapy regimen improves the compliance of patients.
  • Azithromycin is well-tolerated by patients. Two people experienced gastralgia, but neither had to suspend use of the drug.
  • Azithromycin is not phototoxic; therefore, it can be prescribed with safety at all times of the year.

“The results of this study were a bit surprising to me,” said session moderator Guy Webster, MD, professor and vice chairman of dermatology at Jefferson Medical College, in Philadelphia, Pennsylvania. He said he did not expect that azithromycin would show as much anti-inflammatory effect as other more commonly used anti-acne antibiotics, such as doxycycline.

But he said the results may have been surprising because the nature of rosacea continues to be puzzling.

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About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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2 Reader Comments

  1. viviana says:

    La dermatologa me ha indicado para el tratamiento de mi Rosacea AZITRIMICINA en dosis diarias de 5oo mg x 5 días seguidos.como dosis total de tratamiento ademas de uso topici de metronidazol gel y un hidratante diario Cetaphil..será correcto? por favor espero respuesta, ya que he probado varios tratamientos sin éxito y soy alérgica a la Doxiciclina… gracias….

  2. The last comment from Viviana, auto translated

    “The dermatologist has told me to treat my Rosacea AZITRIMICINA in daily doses of 500 mg x 5 days followed by total treatment doses in addition to use of metronidazole gel topici and Cetaphil daily moisturizer is correct ..? Please expect an answer, as I have tried various treatments without success and I am allergic to doxycycline … thanks ….”

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