Rifampicin versus Doxycycline in Prevention of recurrent Boils (A Comparative Therapeutic Study)

Abstract

Background: Suffering from recurrent boils (furunclosis) is a common problem in our locality as it is noticed by many dermatologists especially in association with increasingly hot weather. The most common causative organisms are staphylococci. Objective: The aim of the study was to shed the light upon this problem and compare two systemic therapeutic agents for the prevention of recurrence, doxycycline and rifampicin. Patient and method: One hundred thirty-five (135) Patients with recurrent boils from Al-Yarmouk teaching hospital dermatology outpatient department were included in this study; age ranged from 10 to 64 years old and out of total patients 32 were males and 103 were females. Patients were assessed by full history and clinical examination done by dermatologist. An aspirate from the content of the boil was taken from 30 patients for bacteriological culture. The patients were treated by topical with or without systemic anti-staph antibiotics followed by a preventive protocol of doxycycline100mg twice daily for two months duration in 50 patients and rifampicin 600mg for ten days in the other 85 patients. Both groups used topical sodium fucidate 2% ointment twice daily in nostrils, axilla and perineum for ten days. All were followed up for 2 years to assess the recurrence after treatment. Results: Out of 135 patients treated, 3 (2.22%) patients defaulted from follow up (they were from doxycyclin group) and out of the remainder 132, only 9 (6.8%) patients had recurrence after treatment; 7 (14.89%) patients from the doxycycline group and 3(3.52%) patients from rifampicin group. Forty 40 (85.1%) patients responded well to doxycycline without recurrence for 2 years compared to 83 (97.65%) patients treated with Rifampicin with no recurrence during the 2 years of follow up. The noticed side effects were gastric upset in doxycycline and urine discoloration in rifampicin. Conclusion: Rifampicin regimen in prevention of recurrent boils significantly showed higher effectiveness in addition to more tolerable, easier, shorter course, and fewer side effects than doxycyclin.