***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Some antibiotics represent a mainstay in acne treatment . However , studies comparing their efficacies are rare . Aim : To evaluate the clinical and in vivo antibacterial effect of lymecycline and minocycline at different dosages . Method : Eighty-six patients with moderate to severe acne were enrolled in a r and omized , double-blind , intent-to-treat study comparing in three parallel groups the effect of ( 1 ) lymecycline 300 mg daily for 12 weeks , ( 2 ) minocycline 50 mg daily for 12 weeks and ( 3 ) minocycline 100 mg daily for 4 weeks followed by 50 mg daily for 8 weeks . Evaluations were made at the screening visit and at five on-treatment visits . They consisted of clinical counts of acne lesions and evaluations of bacterial viability using dual flow cytometry performed on microorganisms collected from sebaceous infundibula by cyanoacrylate strippings . Results : Patients receiving minocycline 100/50 mg had the best clinical outcome , particularly in the reduction of the number of papules . By the end of the trial , the microbial response to minocycline 100/ 50 mg was also superior to either of the other two treatments . There were less live and more dead bacteria . Conclusion : In this trial , minocycline 100/50 mg was superior for the treatment of inflammatory acne when compared to lymecycline 300 mg and minocycline 50 mg This multicenter , r and omized , investigator-blinded study compared the efficacy and tolerability of a combination of lymecycline 300 mg/day orally and adapalene topical gel 0.1 % ( n = 118 ) to lymecycline 300 mg/day orally plus vehicle gel ( n = 124 ) in patients with moderate to moderately severe acne vulgaris with both inflammatory and noninflammatory lesions . The primary efficacy end point , total lesion count at end point ( last observation carried forward ) , showed a statistically significant difference in favor of the lymecycline plus adapalene group ( P = .0011 ) . The mean decrease in total , inflammatory and noninflammatory lesion counts was significantly greater at end point in the lymecycline plus adapalene group than in the lymecycline plus vehicle group ( P < .01 ) . In addition , a significant difference for inflammatory and total acne lesions was seen sooner in the adapalene plus lymecycline group . In total , 75.5 % of patients in the lymecycline plus adapalene group were markedly improved , almost clear or clear of their lesions at week 12 , compared with 51.8 % of those in the lymecycline plus vehicle group ( P < .001 ) . Local cutaneous tolerance was generally good in both groups , although more patients receiving the lymecycline plus adapalene combination experienced cutaneous reactions than those receiving lymecycline plus vehicle . There are relatively few studies comparing the efficacy of combined oral and topical therapy with either individual therapy alone . This study clearly demonstrates that lymecycline plus adapalene combination treatment result ed in a significantly greater mean decrease in the number of inflammatory , noninflammatory and total lesions than lymecycline plus vehicle and was well tolerated The efficacy of erythromycin base ( E-Mycin tablets , 333 mg ) and the efficacy of tetracycline hydrochloride ( Panmycin tablets ) were compared in this double-blind , r and omized study . Two hundred patients with moderate to moderately severe acne vulgaris were r and omly assigned to the study . One hundred patients received 1 gm of erythromycin base by mouth per day for 4 weeks , followed by 333 mg/day for 8 weeks , plus placebo for tetracycline . The second group of patients received 1 gm of tetracycline by mouth per day for 4 weeks , followed by 500 mg/day for 8 weeks , plus placebo for erythromycin . Both drugs reduced acne severity to the same extent . Pustules , papules , and open comedo counts decreased significantly over the 12-week period . Seventy-seven percent of the erythromycin-treated patients and 89 % of the tetracycline-treated patients stated that their acne was markedly improved or improved by week 12 . Most of the side effects in patients treated with erythromycin were gastrointestinal symptoms . Among the side effects in patients treated with tetracycline were C and ida vaginitis in one patient and pseudotumor cerebri in one patient BACKGROUND Combination therapy with a topical retinoid and an antibiotic is recognized as a rational and effective approach for the treatment of acne vulgaris .  Adapalene , a naphthoic acid derivative with anti-inflammatory and receptor-selective retinoid properties , is safe and well tolerated . While the combination of adapalene with oral or topical antibiotics has been shown to deliver a superior and faster response than an antibiotic alone , the clinical benefits of a combination of adapalene and doxycycline , the most frequently prescribed oral antibiotic for acne in the United States , have yet to be evaluated . OBJECTIVE AND METHODS In a 12-week study , the efficacy and safety of the combination of adapalene gel 0.1 % with doxycycline was compared with doxycycline alone for the treatment of severe acne . Subjects were r and omized to receive doxycycline once daily in the morning and either adapalene or vehicle once daily in the evening . RESULTS At Week 12 , the combination adapalene-doxycycline was significantly superior to doxycycline alone for change from baseline in total ( p<0.001 ) , inflammatory ( p=0.02 ) , and noninflammatory ( p<0.001 ) lesions . Significant differences in total lesions were observed as early as Week 4 ( p=0.04 ) . Both treatments were well tolerated , and no serious adverse events were reported . CONCLUSIONS The study demonstrates that the combination of adapalene and an oral antibiotic provides a superior and faster benefit than antibiotic therapy alone and should be considered at the initiation of treatment Acne vulgaris is a common inflammatory disorder of the skin . Oral antibiotics are known to be effective in its treatment . A r and omized , investigator‐blinded study was performed to compare the efficacy of azithromycin with doxycycline .  Fifty‐one patients were r and omized to receive either azithromycin 500 mg/day on 3 consecutive days per week in the first , on 2 consecutive days per week in the second , and on 1 day per week in the third month . The other group was given doxycycline twice a day for the first month and once a day for the second and third months . Clinical assessment was made at baseline , at the end of first , second , third , and post‐treatment first and second months . Side effects were recorded . Statistically significant improvement for the facial lesions were obtained with both drugs . Neither drug was shown to be more effective than the other . The beneficial effect continued until 2 months after treatment . In the azithromycin group three patients had diarrohea , while photosensitivity was seen in two patients using doxycycline . This study indicates that azithromycin is at least as effective as doxycycline in the treatment of acne There is a paucity of treatment options for severe acne vulgaris aside from oral isotretinoin . This r and omized , vehicle-controlled , multicenter , double-blind study evaluated the efficacy and safety of combination therapy using adapalene 0.1%-benzoyl peroxide 2.5 % ( A/BPO ) fixed-dose combination gel with doxycycline hyclate 100 mg in the treatment of severe acne vulgaris . A total of 459 participants were r and omized in a 1:1 ratio to receive oral doxycycline hyclate 100 mg once daily and either A/BPO or vehicle once daily for 12 weeks . Efficacy in the A/BPO with doxycycline group was demonstrated as early as week 2 compared with the vehicle arm for total , inflammatory , and noninflammatory lesions ( all P < .005 ) . At week 12 , this combination was superior to vehicle with doxycycline in reducing total , inflammatory , and noninflammatory lesion counts ( an added incremental benefit of 23 % , 24 % , and 21 % , respectively ) , as well as for global success and overall participant satisfaction ( all P < .001 ) . Digital UV fluorescence photography demonstrated a rapid reduction in Propionibacterium acnes in the A/BPO with doxycycline group , particularly within the first 4 weeks . These findings provide evidence on the efficacy of combining A/BPO and the oral antibiotic doxycycline in the treatment of severe acne vulgaris This open , multicenter , comparative , r and omized study included 120 subjects with papulopustular stage of acne vulgaris . Subjects were r and omized to one of the three treatment groups ( A , total dose 4.5 g of azithromycin in 7 weeks ; B , total dose 6.0 g in 10 weeks ; and C , total dose 7.5 g in 13 weeks ) . The aim was to identify the optimum azithromycin dose in the treatment of acne vulgaris through monitoring the efficacy and safety of three dosage regimens . Clinical efficacy was assessed upon completion of study therapy and six months of therapy initiation . Post-therapeutic efficacy assessment was available in 104 subjects . The difference between three treatment groups was most pronounced in the " cure " category ( 36.11 % in group A , 58.82 % in group B and 55.88 % in group C ) and " failure " category ( 8.33 % in group A , and no failures in groups B and C ) . Follow up efficacy assessment was available in 87 subjects . The group percentage of " cure " was lower and group percentage of " treatment failure " higher in group A than in groups B and C. Azithromycin in a total dose of 6.0 g in 10 weeks seems to be a promising agent in the treatment of papulopustular acne vulgaris with few side effects and good patient compliance Abstract Background : Acne vulgaris is the most common dermatological disorder in adolescence and young adults . In past decades , systemic antibiotics have had the main role in the treatment of acne patients with inflammatory papules and cysts . They are sometimes associated with side effects , contributing to reduced compliance . Objective : This study aim ed at comparing the efficacy and safety of oral azithromycin and doxycycline in the treatment of moderate acne vulgaris , considering the age of patients as an influencing parameter . Methods : In a r and omized , double-blind , clinical trial , 100 patients with moderate acne vulgaris who attended the outpatient dermatology clinic were evaluated during a 15-month period . They were r and omized into two equal groups : A and D. Patients in group A received oral azithromycin ( 500 mg daily , 4 consecutive days per month for 3 consecutive months ) and patients in group D took doxycycline ( 100 mg daily for 3 consecutive months ) . The number and types of lesions ( all over the body ) were determined at baseline and at the end of each month for 90 days afterwards . Michaelson 's acne severity score was also determined at baseline and at the end of the third month after initiating treatment . Patients were followed up for another 3 months after discontinuation of treatment to determine the recurrence rate . Results : Both antibiotics were comparably effective in the treatment of moderate acne vulgaris . There was no significant side effect in the A group and the complications were minor in the D group . Doxycycline was significantly more effective in patients older than 18 years . Conclusion : Azithromycin is at least as effective as doxycycline in the treatment of moderate acne vulgaris ; however , in patients older than 18 years  doxycycline is better OBJECTIVE To prospect ively evaluate the association between antibiotics used to treat acne and pharyngitis .  DESIGN Cross-sectional and 9-month prospect i ve cohort . SETTING Urban university setting . PARTICIPANTS University students . INTERVENTION Participants were asked to fill out a survey form , were swabbed for culture , and had a visual examination for acne . MAIN OUTCOME MEASURE Report of pharyngitis . RESULTS In the cross-sectional study , 10 of the 15 students receiving oral antibiotics for acne reported an episode of pharyngitis in the previous 30 days , whereas 47 of the 130 students not receiving oral antibiotics , but who had acne , reported an episode of pharyngitis in the prior month . The unadjusted odds ratio ( OR ) ( 95 % CI ) associating current oral antibiotic use in acne patients with a self-reported episode of pharyngitis was 3.53 ( 95 % CI , 1.14 - 10.95 ) . In the cohort study , there were 358 female and 218 male participants ; 36 ( 6.2 % ) received oral antibiotics for acne during the study , and 96 ( 16.6 % ) received topical antibiotics for acne . Using mixed model logistic regression , the OR was 4.34 ( 95 % CI , 1.51 - 12.47 ) associating oral antibiotic use with 
    Output:
    
Results Tetracyclines , macrolides , and trimethoprim/sulfamethoxazole are effective and safe in the treatment of moderate to severe inflammatory acne .
The combination of oral antibiotics with a topical therapy is superior to oral antibiotics alone .