Efficacy of Oral Azithromycin versus Oral Doxycycline in Treating Moderate Acne Vulgaris and Their Effects on Patients' Quality of Life

This study aimed to compare the efficacy of oral azithromycin with oral doxycycline in moderate acne vulgaris and to assess the corresponding changes in patient-reported quality-of-life. In this open label, randomised controlled trial conducted at a university student clinic, Muscat, Oman, 163 patients with moderate and severe acne vulgaris were assigned equally to receive either oral azithromycin or oral doxycycline. Treatments were administered over a three-month period with monthly clinical assessments. Acne severity was quantified using a validated acne severity scale, and quality of life was measured at baseline and at study end via a standardised questionnaire. Analyses were performed using univariate statistics. The cohort comprised 163 participants (mean age 20.2 ± 1.7 years; 67.3% female). Both groups experienced significant and comparable reductions in acne severity after three months. Parallel, statistically significant improvements were observed in quality-of-life scores across domains related to symptoms, emotional well-being, and social functioning. Oral azithromycin and doxycycline demonstrate equivalent efficacy in reducing moderate acne vulgaris and both confer substantial enhancements in patients’ quality of life. These findings support either antibiotic as an appropriate option for addressing both the dermatological and psychosocial burdens of moderate acne. The trial was registered with the Australia New Zealand Clinical Trial Registry (ACTRN12619000073101; Date: 18th of January 2019).