Antibiotic Resistance in Acne Treatment

Adler, Brandon; Kornmehl, Heather; Armstrong, April W.

doi:10.1001/jamadermatol.2017.1297

Cited by 68 publications

(63 citation statements)

References 7 publications

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“…Acne vulgaris is a disease of the pilosebaceous unit, characterized by release of inflammatory mediators, hyperkeratinization, increased sebum production, and Cutibacterium acnes colonization [1]. Hypersensitivity of the glands to normal circulating androgen levels is common in acne [2].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Tracnil™ Administration in Patients with Dermatological Manifestations of PCOS: An Open-Label Single-Arm Study

Ramanan¹,

Ravi²,

Anbu

et al. 2020

Dermatology Research and Practice

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Myo-inositol’s role in improving acne by reducing hyperandrogenism has been demonstrated in PCOS patients. Inositol and associated molecules display inhibitory properties against 5-α reductase, COX-2, and lipase enzymes in addition to their antimicrobial and anti-inflammatory properties. However, the role of myo-inositol is not well established in women patients with normal hormone levels but with clinical manifestations of PCOS. In this study, we evaluate the efficacy of Tracnil™, a combination of myo-inositol with folic acid and vitamin D3, in resolving acne in overweight women of menstruation age displaying normal hormone levels. It is a single-arm study conducted at 2 centers including 33 women with acne, hirsutism, and menstrual irregularities. Acne and hirsutism were assessed by manual lesion count, modified Cook’s scale, and modified Ferriman–Gallwey hirsutism score (mFGHS). Hormone levels and safety parameters were assessed throughout the study. Our results show that Tracnil™ monotherapy could drastically reduce acne-related lesions of both inflammatory and noninflammatory types as quickly as 8 weeks. Additionally, it improves hirsutism and menstrual irregularities. Adverse reactions were negligible during the whole study period with no drastic side effects reflected by a modulatory effect on hormone levels. Despite the subjects having normal hormone levels, the acne treatment with myo-inositol and vitamin D3 shows improvement in hirsutism and regularization of menstrual cycle. Therefore, we attribute the mechanism of action of Tracnil™ to modulation of receptor sensitivity to sex hormones or other downstream processing events. Tracnil™ may be considered as a first-line treatment for dermatological manifestations of PCOS even in the absence of significant hormonal abnormalities. This treatment is practically implementable in a dermatologists’s office practise.

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Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Tracnil™ Administration in Patients with Dermatological Manifestations of PCOS: An Open-Label Single-Arm Study

Ramanan¹,

Ravi²,

Anbu

et al. 2020

Dermatology Research and Practice

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“…Although truncal acne is expected to respond to therapy in a similar manner as acne on the face, the challenges of topical application, particularly to the back, are obvious, making patient compliance a challenge. As such, dermatologists have frequently resorted to prescribing oral antibiotics for these large and hard-to-reach body areas in contravention of the American Academy of Dermatology guidelines [8] and potentially increasing the growing problem of antibiotic resistance. It is currently estimated that more than 50% of C. acnes strains are resistant to topical macrolide antibiotics [9]; therefore, physicians have a duty to evaluate and prescribe appropriate alternative treatments.…”

Section: Introductionmentioning

confidence: 99%

Topical Treatment of Truncal Acne with Tretinoin Lotion 0.05% and Azelaic Acid Foam

Surin-Lord

Miller²

2020

Case Reports in Dermatological Medicine

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Truncal acne is present in approximately half of all patients with facial acne but is also occasionally seen in isolation. Important considerations when selecting treatment options for adult female acne, whether on the face, back, chest, or shoulders, include patient compliance, treatment response time, tolerability of the treatment, and psychosocial impact of the disease. Oral antibiotics are widely prescribed for truncal acne due to the challenges of applying topical therapy to such an extensive body surface area. In cases of severe inflammatory and nodular acne vulgaris, this may be a reasonable consideration; however, oral antibiotics should only be used for short durations. Overprescription contributes to microbial resistance and may cause disruption of the gastrointestinal microbiome. In many cases of mild, moderate, or even severe truncal acne, combinations of topical therapies may be valid alternatives. The introduction of foam formulations with enhanced percutaneous absorption and tretinoin lotion formulations that incorporate moisturizing/hydrating agents challenges the previously held idea that effective and tolerable treatment of truncal acne requires oral treatment. This case series describes four female African-American patients with truncal acne successfully treated with a combination of tretinoin lotion 0.05% and azelaic acid 15% foam.

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“…A large number of acne treatments are available, including benzoyl peroxide, antibiotics, and retinoids. Being a multifactorial disease, combination therapy is often recommended, and the treatment of choice depends on acne severity and presence or absence of inflammatory and/or non‐inflammatory acne lesions . In order to target the major mechanisms of the acne pathogenesis, patients with more severe acne are typically prescribed either systemic antibiotics in combination with a topical agent or systemic isotretinoin .…”

Section: Introductionmentioning

confidence: 99%

“…Both treatment modalities are associated with potential problems. With antibiotics, there is a risk of developing resistant strains of C. acnes and other bacteria , whereas isotretinoin is teratogenic and can cause a number of adverse effects maybe including depression . Since the above‐mentioned therapies need to be administered daily, patient adherence is mandatory and compliance issues especially with topical treatments are not rare.…”

Section: Introductionmentioning

confidence: 99%

Acne Treatment With Light Absorbing Gold Microparticles and Optical Pulses: An Open‐Label European Multi‐Centered Study in Moderate to Moderately Severe Acne Vulgaris Patients

et al. 2019

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Background and Objective: Recently, a novel acne treatment based on selective photothermolysis of pilosebaceous units with follicular delivery of inert gold microparticles as an exogenous chromophore and diode laser pulses has been developed. To evaluate the efficacy and safety of a single monotherapy treatment regimen with gold microparticles and diode laser exposure in patients with moderate and moderately severe acne. Further, to evaluate the added benefit of a second treatment regimen combined with pharmaceutical acne treatment in patients with inadequate initial response. Materials and Methods: Patients with moderate and moderately severe facial acne were recruited in this openlabel, pilot study. A single treatment regimen consisted of three weekly facial treatments with topically applied gold microparticles and diode laser pulses. Outcome measures were the proportion of patients with ≥40% improvement in number of acne lesions (weighted lesion count [WLC]) at 12 weeks (single treatment regimen, primary outcome measure), 24, and 36 weeks from baseline (two treatment regimens), safety, and patient satisfaction. Results: A total of 28 patients were enrolled in the study (18 males, 10 females, 19 patients with moderate acne severity, 9 with moderately severe, mean age: 19.8 years). Twenty-five patients underwent analysis for outcome measures. After a single monotherapy treatment regimen, 76% patients (19/25) achieved ≥40% reduction in WLC (mean WLC reduction: 63%; SD: 13%). Of the patients undergoing two treatment regimens (n = 9 patients), 56% experienced a reduction in acne lesion burden (WLC) ≥40% at 24 weeks and 89% 36 weeks post-baseline. Mean pain score was 4.0 (SD: 1.3), and transient erythema and perifollicular edema were commonly noted after treatment. Most patients (81%) were either "satisfied" or "very satisfied" with the treatment. Conclusion: Acne therapy based on selective photothermolysis with gold microparticles shows promise and may be used in treatment of moderate to moderately severe acne.

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Antibiotic Resistance in Acne Treatment

Cited by 68 publications

References 7 publications

Efficacy and Safety of Tracnil™ Administration in Patients with Dermatological Manifestations of PCOS: An Open-Label Single-Arm Study

Efficacy and Safety of Tracnil™ Administration in Patients with Dermatological Manifestations of PCOS: An Open-Label Single-Arm Study

Topical Treatment of Truncal Acne with Tretinoin Lotion 0.05% and Azelaic Acid Foam

Acne Treatment With Light Absorbing Gold Microparticles and Optical Pulses: An Open‐Label European Multi‐Centered Study in Moderate to Moderately Severe Acne Vulgaris Patients

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