Effects of Subantimicrobial-Dose Doxycycline in the Treatment of Moderate Acne

Skidmore, Robert A.; Kovach, Rodney; Walker, Clay; Thomas, John G.; Bradshaw, Mark; Leyden, James J.; Powala, Christopher; Ashley, Robert A.

doi:10.1001/archderm.139.4.459

Cited by 198 publications

(158 citation statements)

References 14 publications

(22 reference statements)

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“…151 Importantly, some oral antibiotics, especially tetracycline derivatives, in addition to antibiotic activity against P acnes, exhibit certain antiinflammatory and immunomodulatory properties that may be operative in counteracting mechanisms or pathways involved in acne lesion development. 60,[153][154][155] Typically, 4 to 8 weeks of compliant oral antibiotic use are needed before the clinical effects of an oral antibiotic are visible, whereas maximal response may require 3 to 6 months of administration. 15,70 Once the formation of new inflammatory lesions, defined as lesions that are raised by palpation, are markedly diminished in number, consideration may be given to stopping oral antibiotics with continuation of topical therapy to maintain control of acne.…”

Section: Adding An Oral Antibioticmentioning

confidence: 99%

Evidence-Based Recommendations for the Diagnosis and Treatment of Pediatric Acne

et al. 2013

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INTRODUCTION: Acne vulgaris is one of the most common skin conditions in children and adolescents. The presentation, differential diagnosis, and association of acne with systemic pathology differs by age of presentation. Current acknowledged guidelines for the diagnosis and management of pediatric acne are lacking, and there are variations in management across the spectrum of primary and specialty care. The American Acne and Rosacea Society convened a panel of pediatric dermatologists, pediatricians, and dermatologists with expertise in acne to develop recommendations for the management of pediatric acne and evidence-based treatment algorithms. METHODS: Ten major topic areas in the diagnosis and treatment of pediatric acne were identified. A thorough literature search was performed and articles identified, reviewed, and assessed for evidence grading. Each topic area was assigned to 2 expert reviewers who developed and presented summaries and recommendations for critique and editing. Furthermore, the Strength of Recommendation Taxonomy, including ratings for the strength of recommendation for a body of evidence, was used throughout for the consensus recommendations for the evaluation and management of pediatric acne. Practical evidence-based treatment algorithms also were developed. RESULTS: Recommendations were put forth regarding the classification, diagnosis, evaluation, and management of pediatric acne, based on age and pubertal status. Treatment considerations include the use of over-the-counter products, topical benzoyl peroxide, topical retinoids, topical antibiotics, oral antibiotics, hormonal therapy, and isotretinoin. Simplified treatment algorithms and recommendations are presented in detail for adolescent, preadolescent, infantile, and neonatal acne. Other considerations, including psychosocial effects of acne, adherence to treatment regimens, and the role of diet and acne, also are discussed. CONCLUSIONS: These expert recommendations by the American Acne and Rosacea Society as reviewed and endorsed by the American Academy of Pediatrics constitute the first detailed, evidence-based clinical guidelines for the management of pediatric acne including issues of special concern when treating pediatric patients.

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Section: Adding An Oral Antibioticmentioning

confidence: 99%

Evidence-Based Recommendations for the Diagnosis and Treatment of Pediatric Acne

et al. 2013

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“…Doxycycline when used alone or in combination with Benzoyl peroxide has retained its efficacy, and the efficacy is greater when combined with topical benzoyl peroxide. 13 Clindamycin either alone or in combination with topical benzoyl peroxide 5% cream shows greater efficacy than doxycycline either alone or in combination with topical benzoyl peroxide 5% cream. The reason for lesser efficacy of doxycycline could be due to development of resistance by propionibacterium acne in some of the patients included in this trial.…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetic study of rational regimen of oral clindamycin in comparison with doxycycline in mild cases of acne vulgaris

Arivazhagan

Kumar

2017

Int J Basic Clin Pharmacol

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Background: Acne vulgaris is a chronic inflammatory disease of pilosebaceous units. It is a common skin disorder affecting both boys and girls in the adolescent age group and also extends into the post adolescent age group. From time immemorial, various remedies have been suggested and followed by Ayurvedic, Siddha, Unani practitioners and native healers present in various parts of the world. In this study an attempt has been made to evaluate the efficacy of a low dose oral Clindamycin in Acne vulgaris and the results of the study have been presented in ensuing chapters.Methods: The Prospective, Randomized Controlled, Single blind study was conducted in Out Patient Section, Department of Dermatology, tertiary care teaching hospital September 2016 to May 2017 for Total six weeks. Drug administration - four weeks. Follow up - two weeks mostly drug used Capsule Clindamycin 50mg. Capsule Doxycycline 100 mg. Benzoyl Peroxide 5% topical cream.Results: The objective of the study is not only to find out the efficacy of a low dose of 50 mg Clindamycin given orally, but also to find out if this efficacy is obtained without producing the adverse effects for which the administration of Clindamycin is hesitated the ant-microbial, Cap. Doxycycline and Cap. Clindamycin act in acne vulgaris by their effect on the Propionibacterium acne. These antibiotics decrease the population of Propionibacterium acne which in turn leads to the inhibition of the bacterial lipases and this is followed by a decrease in concentration of free fatty acids. This produces less tissue inflammation and acne.Conclusions: This study proves the safety and efficacy of low dose of oral Clindamycin in acne vulgaris, and such low doses can also be tried for other infections where the causative organism responds to Clindamycin.

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“…31 Dosing of Doxycycline in acne vulgaris has become another interesting area of research since the drug was found to be significantly effective in few occasions even at a sub antimicrobial dose level (20mg twice daily) while treating moderate facial acne cases. 32,33 A very recent study with larger sample size has shown that a modified release sub antimicrobial dose of Doxycycline (40mg once daily) was not only effective as 100mg daily dose but also appeared better in terms of safety in the treatment of moderate to severe inflammatory acne. 34 Lately, an in vitro study focusing the anti-inflammatory property of Doxycycline also indicated that the drug could be safely used at a low dose (20-40mg daily) in chronic or acute skin diseases where inflammation has to be controlled or prevented.…”

Section: Discussionmentioning

confidence: 99%

A randomized controlled open label comparative clinical study of cephalexin versus doxycycline in patients with acne vulgaris in a hospital based population of South India

Banerjee

Maity

Bubna

et al. 2017

Int J Basic Clin Pharmacol

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Background: Oral antibiotics are frequently used for acne vulgaris. Cephalexin has documented some success against acne vulgaris in earlier studies. Here the efficacy and safety of Cephalexin have been compared against the standard therapy of Doxycyline.Methods: From September 2010 to June 2011, 100 patients of moderate Acne vulgaris were randomized into two groups to receive oral Doxycyline (100mg once daily) or Cephalexin (500mg thrice daily) in an open label manner for eight weeks. All participants were allowed to use topical 5%Benzoyl peroxide gel twice daily. Efficacy was measured in terms of reduction in the number of facial comedones and inflammatory lesions from baseline after eight weeks.Results: 44 patients from Cephalexin group and48 patients from Doxycyline group completed the study. Both drugs have significantly decreased comedone count as well as the inflammatory lesion count after eight weeks. However, Doxycycline appeared better in terms of Comedone count (14.5±3.07 versus 12.9±4.31, p=0.045) as well as inflammatory lesion count (8.64.1±2.14 versus 7.67±2.46, p=0.047) at the end. The total adverse event was slightly more with Cephalexin (6.81% versus 6.25%, p= 0.912), where Diarrhoea remained the commonest adverse effect (4.54%).Conclusions: Although for the first time oral Cephalexin has displayed efficacy against moderate acne vulgaris in a prospective clinical study, it appeared inferior to Doxycycline over eight weeks. Therefore, it becomes an option only when other oral antibiotics are contraindicated or not tolerated.

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Effects of Subantimicrobial-Dose Doxycycline in the Treatment of Moderate Acne

Cited by 198 publications

References 14 publications

Evidence-Based Recommendations for the Diagnosis and Treatment of Pediatric Acne

Evidence-Based Recommendations for the Diagnosis and Treatment of Pediatric Acne

Pharmacokinetic study of rational regimen of oral clindamycin in comparison with doxycycline in mild cases of acne vulgaris

A randomized controlled open label comparative clinical study of cephalexin versus doxycycline in patients with acne vulgaris in a hospital based population of South India

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