Meta-analysis comparing efficacy of antibiotics versus oral contraceptives in acne vulgaris.

Abstract

BACKGROUND:

Both antibiotics and oral contraceptive pills (OCPs) have been found to be effective in managing acne vulgaris. Despite widespread use, few direct comparisons of efficacy between the 2 modalities have been published.

OBJECTIVE:

We compared the efficacy of antibiotics and OCPs in managing acne.

METHODS:

A meta-analysis was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Cochrane collaboration guidelines.

RESULTS:

A review of 226 publications yielded 32 randomized controlled trials that met our inclusion criteria. At 3 and 6 months, compared with placebo, both antibiotics and OCPs effected greater percent reduction in inflammatory, noninflammatory, and total lesions; the 2 modalities at each time point demonstrated statistical parity, except that antibiotics were superior to OCPs in percent reduction of total lesions at 3 months (weighted mean inflammatory lesion reduction: 3-month course of oral antibiotic treatment = 53.2%, 3-month course of OCPs = 35.6%, 3-month course of placebo treatment = 26.4%, 6-month course of oral antibiotic treatment = 57.9%, 6-month course of OCPs = 61.9%, 6-month course of placebo treatment = 34.2%; weighted mean noninflammatory lesion reduction: 3-month course of oral antibiotic treatment = 41.9%, 3-month course of OCPs = 32.6%, 3-month course of placebo treatment = 17.1%, 6-month course of oral antibiotic treatment = 56.4%, 6-month course of OCPs = 49.1%, 6-month course of placebo treatment = 23.4%; weighted mean total lesion reduction: 3-month course of oral antibiotic treatment = 48.0%, 3-month course of OCPs = 37.3%, 3-month course of placebo treatment = 24.5%, 6-month course of oral antibiotic treatment = 52.8%, 6-month course of OCPs = 55.0%, 6-month course of placebo treatment = 28.6%).

LIMITATIONS:

Investigative treatment heterogeneity and publication bias are limitations.

CONCLUSIONS:

Although antibiotics may be superior at 3 months, OCPs are equivalent to antibiotics at 6 months in reducing acne lesions and, thus, may be a better first-line alternative to systemic antibiotics for long-term acne management in women.

• Authors: Eubee Baughn Koo, Tyler Daniel Petersen, Alexandra Boer Kimball
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 71 Issue 3 Pg. 450-9 (Sep 2014) ISSN: 1097-6787 [Electronic] United States
• PMID: 24880665 (Publication Type: Comparative Study, Journal Article, Meta-Analysis)
• Copyright: Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• Contraceptives, Oral
• Contraceptives, Oral, Combined
• Progestins
• Tetracyclines
• Estradiol

Topics

• Acne Vulgaris (drug therapy)
• Anti-Bacterial Agents (therapeutic use)
• Contraceptives, Oral (therapeutic use)
• Contraceptives, Oral, Combined (therapeutic use)
• Estradiol (administration & dosage)
• Female
• Humans
• Progestins (administration & dosage)
• Tetracyclines (therapeutic use)
• Treatment Outcome