Treatment of Acne Vulgaris Using the Combination of Topical Erythromycin and Miconazole

Acne vulgaris is a multifactorial disease of the pilosebaceous unit. Malassezia furfur is one of the causative agents of the disease.It provides a proper environment for Propionibacterium to grow. Miconazole inhibits the Propionibacterium growth by its fungicidal activity. The aim of this study was to evaluate the treatment of Acne vulgaris using the combination of topical erythromycin and miconazole. In a single-blinded randomized clinical trial, 60 patients who were referred to the dermatology clinics of Isfahan University of Medical Sciences with mild to moderate acne vulgaris were selected by simple random sampling method. The patients were randomly allocated to two groups. One group was treated with 2% erythromycin alcoholic solution and the other group was treated with 2% erythromycin and 2% miconazole alcoholic solution. Patients were followed up each month for three months. The efficacy of treatment was evaluated by the Acne Severity Index (ASI) and the data were analyzed by the SPSS. In the second and the third months of treatment, ASI and inflammatory acne lesions significantly reduced in the erythromycin plus miconazole group in comparison to the erythromycin group (P < 0.05). Efficacy of erythromycin plus miconazole in reduction of acne lesions was moderate and excellent in the second and third months of treatment, respectively. Both treatment methods were highly effective in reducing the inflammatory lesions (papules and pustules) and were least effective in noninflammatory lesions (comedones). This study showed that erythromycin plus miconazole alcoholic solution is effective in treating the mild to moderate acne lesions as an adjuvant therapy.