Comparison of Low-Dose Treatment of Isotretinoin and Flutamide Combined with Oral Erythromycin for Female Patients with Severe Acne

Background & objectives: Acne is a chronic inflammation of pilosebaceous units and in severe form reflects a different response to treatment in an oral regime of antibiotics. The purpose of this study is to compare the effect of the combination of erythromycin and low dose oral isotretinoin with erythromycin and low dose flutamide in women suffering from severe acne. Methods: In a randomized controlled clinical trial, 80 women suffering from severe acne participated in the study and they were studied for 2 months. The first group received 800 mg oral erythromycin, together with 20 mg oral isotretinoin every two days and the second group received 800 mg erythromycin, together with 62.5 mg flutamide daily. The treatment efficiency was evaluated by the count of acne lesions and computing the acne severity index. The data of the study were analyzed using the version 16 of spss software. Results: In the present study, 40 patients participated in the research in each group. Finally, 61 people completed the study. The mean acne severity index in the flutamide group was 195.9±15 at the beginning of treatment and this index reduced to 52.8±5.8 at the end of treatment. The mean acne severity index in the isotretinoin group was 247.8±19.7 at the beginning of treatment and this index reduced to 76.3±12.5 at the end of treatment. The difference in reduction between the two groups was not statistically significant (p=0.15). Conclusion: The treatment effectiveness of the above-mentioned methods in female severe acne was acceptable and this combination therapy can be presented as a better alternative compared to treatments with high dose individual treatment including oral isotretinoin and oral flutamide.