Active Ingredients: Azithromycin
+ free Zithromax pill.
Both minocycline and doxycycline are also associated with candida vaginitis.
Additionally, minocycline and doxycycline are placed in Pregnancy Category D, which includes drugs that have some significant risks and that should be used during pregnancy only when the alternatives are worse.
In contrast, azithromycin is a Pregnancy Category B drug, which category includes drugs that are used routinely and safely during pregnancy and which are considered safe to use if there is a clinical need for the drug. The Fernandez-Obregon study treated patients suffering from at least 12 lesions of inflammatory acne, defined as papules, pustules, or cysts.
Patients were graded on the reduction of the number of lesions associated with each treatment. The Fernandez-Obregon article did not distinguish between the various types of inflammatory lesions and it is possible, if not likely, that none of the patients treated had nodular or cystic lesions, or had at most one or two such lesions.
Also, because nodular or cystic acne is considered to be a distinct form of acne requiring specific therapy and the intent of the Fernandez-Obregon study was to compare the efficacy of azithromycin to that of other antibiotics, which are known in the art to be efficacious to treat papular and pustular inflammatory lesions but not nodular or cystic lesions, it is evident to one of skill of the art that the patients treated in the Fernandez-Obregon study, although possibly having one or two cystic lesions, would not have been included in the study if they had been suffering from a distinct and more severe nodular acne.
Singhi compared azithromycin given at a dose of 500 mg for three consecutive days in a 10 day cycle with doxycycline given daily to a population of individuals suffering from moderate to severe inflammatory acne.
Each of the individuals also received topical erythromycin therapy throughout the study. Each of the patients was graded for severity of acne prior to commencement of therapy and at the end of therapy.
The severity of acne was graded counting the number of comedones, papules, pustules, infiltrated, and cystic lesions, multiplying the number of each type of lesion by the lesions severity index 0.
Like Fernandez-Obregon, Singhi does not disclose that any of the subjects studied suffered from nodular acne and there is no suggestion that any of the subjects had multiple acne nodules.
The results of Singhi were disclosed to be similar to those of Fernandez-Obregon and showed that azithromycin is an effective medication for treating moderate to severe acne vulgaris.
It is clear from the disclosures of Fernandez-Obregon and Singhi that nodular acne was not treated in their studies. Because an effective therapy for nodular acne that does not produce the severe side effects of isotretinoin has long been sought, if either of these studies had shown an effective antibiotic therapy against nodular or cystic acne, this result would have been proclaimed clearly as a breakthrough in acne therapy.