L’azitromicina: una nuova arma per la terapia sistemica delle manifestazioni acneiche infiammatorie

Aim. Azithromycin is an azalide antimicrobial agent active in skin infections with Propionibacterium acnes and in the literature there are no reports of PA resistance against it. Azithromycin has pharmacokinetic properties that give the possibility of pulse-therapies. It also has anti-inflammatory activity and it is not photo-active. The aim of this report is to show the efficacy and tolerability of azithromycin in the treatment of inflammatory acne, inflammatory rosacea and perioral dermatitis. Methods. An open study was carried out on 52 patients including: 40 patients affected by inflammatory acne, 6 patients with inflammatory rosacea and 6 patients with perioral dermatitis. In all these patients the basic treatment scheduled was azithromycin 500 mg/day for 3 consecutive days a week for 4 weeks. Results. The treated cases of inflammatory acne, inflammatory rosacea and perioral dermatitis showed a marked reduction of signs and symptoms after the scheduled azithromycin dosage. Conclusions. On the basis of these results, azithromycin is effective in about 75% of patients, e.g. the same percentage reached by means of the use of other oral antibiotics. The advantages of this scheme of treatment may be summarized as follows: - the pulse therapy significantly increases patients' compliance, because of the reduced total number of administrations of the drug; furthermore, it is well accepted by younger patients' parents; - good tolerability; - the drug is not phototoxic: therefore, it may be used with safety also in the summertime; - no case of P. acnes resistance have been up to now recorded in the literature.