New antibiotic therapies for acne and rosacea

Mays, Rana; Gordon, Rachel A.; Wilson, Janice; Silapunt, Sirunya

doi:10.1111/j.1529-8019.2012.01497.x

Cited by 27 publications

(24 citation statements)

References 62 publications

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“…They exhibit their effects via both antimicrobial and direct anti-inflammatory properties. Specifically, antibiotics have been shown to inhibit bacterial lipase, down-regulate inflammatory cytokines, prevent neutrophil chemotaxis, and inhibit MMPs [68][69][70].…”

Section: Oral Antibioticsmentioning

confidence: 99%

Recent Advances in Acne Pathogenesis: Implications for Therapy

2014

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Acne pathogenesis is a multifactorial process that occurs at the level of the pilosebaceous unit. While acne was previously perceived as an infectious disease, recent data have clarified it as an inflammatory process in which Propionibacterium acnes and innate immunity play critical roles in propagating abnormal hyperkeratinization and inflammation. Alterations in sebum composition, and increased sensitivity to androgens, also play roles in the inflammatory process. A stepwise approach to acne management utilizes topical agents for mild to moderate acne (topical retinoid as mainstay ± topical antibiotics) and escalation to oral agents for more resistant cases (oral antibiotics or hormonal agents in conjunction with a topical retinoid or oral isotretinoin alone for severe acne). Concerns over antibiotic resistance and the safety issues associated with isotretinoin have prompted further research into alternative medications and devices for the treatment of acne. Radiofrequency, laser, and light treatments have demonstrated modest improvement for inflammatory acne (with blue-light photodynamic therapy being the only US FDA-approved treatment). However, limitations in study design and patient follow-up render these modalities as adjuncts rather than standalone options. This review will update readers on the latest advancements in our understanding of acne pathogenesis and treatment, with emphasis on emerging treatment options that can help improve patient outcomes.

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Section: Oral Antibioticsmentioning

confidence: 99%

Recent Advances in Acne Pathogenesis: Implications for Therapy

2014

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“…As already stated, although acne is not an infectious disease, oral antibiotics have remained a mainstay of treatment over the last 40 years. The anti-inflammatory properties of oral antibiotics, particularly cyclines, are effective in treating inflammatory acne [39,40] All the guidelines -French[41], European [42] and American[43] -recommend cycline for first treatment but limited to a treatment period of three months to minimize the development of bacterial resistance. This is why the treatment duration of the comparator arm we chose is doxycycline 100 mg/day for three months.…”

Section: Interventions Explanation For the Choice Of Comparators {6b}mentioning

confidence: 99%

FASCE, the benefit of spironolactone for treating acne in adult females: study protocol for a randomized double-blind trial

Poinas

Lemoigne

Naour

et al. 2020

Preprint

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Background: Acne vulgaris of adult females has increased over the past 10 years; it affects currently 20 to 30% of adult females. The physiopathology of adult female acne is distinguished from that of teenagers essentially by two factors: hormonal and inflammatory. On a therapeutic plan, in female acne, four types of systemic treatment approved in this indication include: cyclines (leading to bacterial resistance); zinc salts (less effective than cyclines); and antiandrogens (risks of phlebitis). The last alternative is represented by isotretinoin, but its use in women of childbearing potential is discouraged because of the teratogen risks.In this context, spironolactone could represent an interesting alternative. It blocks the 5-alpha-reductase receptors at the sebaceous gland and inhibits LH production at the pituitary level. It has no isotretinoin constraints and does not lead to bacterial resistance. Currently, a very few studies have been performed on a limited number of patients. They showed that at low doses (lower than 200 mg/day), spironolactone can be effective against acne.In that context, it seemed clearly interesting to perform the first double-blind randomized study of spironolactone vs cyclines, which remains the moderate acne reference treatment, and to demonstrate the superiority of spironolactone’s efficacy in order to establish it as an alternative to cyclines.Methods: Two hundred female patients will be included. They will have acne vulgaris with at least ten inflammatory lesions and no more than three nodules. After randomization, the patients will be treated by spironolactone or doxycycline for three months and after placebo. The study will be blind for the first six months and open for the last six months. Discussion: The treatment frequently used in female acne is systemic antibiotics with many courses as it is a chronic inflammatory disease. In the context of the recent WHO revelation about the serious, worldwide threat to public health of antibiotic resistance, this trial could give the physician another alternative for adult female acne before using isotretinoin, whose management is more complex. Trial registration: On ClinicalTrials.gov, registration number NCT03334682, first published on 7 November, 2017. Recruitment is still ongoing.

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“…Another factor that can inuence the results, would be the presence of residual PBO in the polymer, this compound has antibacterial action, being used in the pharmaceutical industry in the formulation of medications for the treatment of acne. [24][25][26] In Fig. 13, it is possible to observe the variation of the peroxide index throughout the reaction for the terpolymer MAA/ MMA/STY.…”

Section: Antifungal Activity Of Polymersmentioning

confidence: 99%