Published online November 1, 2006
PEDIATRICS Vol. 118 No. 5 November 2006, pp. 2257a-2258 (doi:10.1542/peds.2006-2312)
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LETTER TO THE EDITOR

Azithromycin for Pityriasis: In Reply

Ahdi Amer, MD
Howard Fischer, MD
Wayne State University School of Medicine
The Carman and Ann Adams Department of Pediatrics
Children's Hospital of Michigan
Detroit, MI 48201

We tried to duplicate the study of Sharma et al,1 in which a remarkable 73% of the patients with pityriasis rosea were cured within 2 weeks by erythromycin and no patient in the placebo group was cured. In our study, 10 patients (42%) in the placebo group had resolution of their lesions within 2 weeks of enrollment, and 17 (71%) had resolution within 3 weeks. We are puzzled that there were no cases of complete resolution in their placebo group.

We agree that azithromycin is not erythromycin, and that although the 2 drugs show a near-identical antimicrobial spectrum of action and share many immunomodulatory and antiinflammatory effects, there may be some differences between them. The 95% confidence interval calculated for the absolute risk reduction by Clavier and Hupert includes the value of 0, which indicates that the treatment arm was not significantly different from the placebo arm. Thus, we did not find a significant treatment effect. Until the results of Sharma et al are confirmed, we do not think it rational to try to treat pityriasis rosea with macrolide or azalide antibiotics.

REFERENCE

  1. Sharma PK, Yadav TP, Gautam RK, Taneja N, Satyanarayana L. Erythromycin in pityriasis rosea: a double blind, placebo-controlled clinical trial. J Am Acad Dermatol. 2000;42 :241 –244[CrossRef][ISI][Medline]
PEDIATRICS (ISSN 1098-4275). ©2006 by the American Academy of Pediatrics




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