Systemic Antibiotics for Acne

Meynadier, J; Alirezai, M.

doi:10.1159/000017847

Cited by 61 publications

(39 citation statements)

References 50 publications

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“…For the antibiotic therapy, tetracycline, erythromycin, and lincomycin are generally used in the treatment [6,7]. With the increasing of antibiotic application, the increased prevalence of the antibiotic resistant bacteria has been reported [24]. Also, it has been previously reported on the antibiotic resistance of acne-related bacteria.…”

Section: Antibiotic Resistance Of Acne-related Bacteria Against Commementioning

confidence: 99%

Synergistic Antibacterial Effects of Chitosan-Caffeic Acid Conjugate against Antibiotic Resistant Acne-Related Bacteria

Kim

Eom

et al. 2017

Preprint

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Abstract:The object of this study was to discover an alternative therapeutic agent with fewer side effects against acne vulgaris, which is one of the most common skin diseases. Acne vulgaris often associates with acne-related bacteria such as Propionibacterium acnes, Staphylococcus epidermidis, Staphylococcus aureus and Pseudomonas aeruginosa, some of which exhibit a resistant against commercial antibiotics used in the treatment of acne vulgaris (tetracycline, erythromycin, and lincomycin). In the current study, we evaluated in vitro antibacterial activity of chitosanphytochemical conjugates against acne-related bacteria. Three of chitosan-phytochemical conjugates used in this study showed stronger antibacterial activity than that of chitosan (unmodified control). Chitosan-caffeic acid conjugate (CCA) exhibited the highest antibacterial activity against acne-related bacteria with minimum inhibitory concentration values of 8 μg/mL to 256 μg/mL. In addition, the MICs of antibiotics against antibiotic resistant P. acnes and P. aeruginosa strains were dramatically reduced in the combination with CCA, suggesting that CCA would restore the antibacterial activity of the antibiotics. The analysis of fractional inhibitory concentration indices clearly revealed a synergistic antibacterial effect between CCA and the antibiotics. Thus, the median ∑FIC values against the antibiotic resistant bacterial strains were ranged from 0.375 to 0.533 in the combination mode of CCA and antibiotics.

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Section: Antibiotic Resistance Of Acne-related Bacteria Against Commementioning

confidence: 99%

Synergistic Antibacterial Effects of Chitosan-Caffeic Acid Conjugate against Antibiotic Resistant Acne-Related Bacteria

Kim

Eom

et al. 2017

Preprint

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“…Similarly, Jatoi et al analysed the effect of an oral tetracycline prophylaxis on the development of skin exanthemas of a grade greater than or equal to 2, and found that prophylaxis with tetracycline was effective during the first weeks, but ineffective in a longterm setting (9). These antibiotics are commonly used for the treatment of acne, and the clinical similarity between classical acne and an eGFr inhibitor-induced skin exanthema suggests that this antibiotic may play a role in preventing or treating drug-induced exanthemas (10,11). however, tetra-/doxy-/ and minocycline carry anti-inflammatory effects that may also support exanthema palliation (11,12).…”

Section: Cetuximab-induced Skin Exanthema: Improvement By a Reactive mentioning

confidence: 99%

“…These antibiotics are commonly used for the treatment of acne, and the clinical similarity between classical acne and an eGFr inhibitor-induced skin exanthema suggests that this antibiotic may play a role in preventing or treating drug-induced exanthemas (10,11). however, tetra-/doxy-/ and minocycline carry anti-inflammatory effects that may also support exanthema palliation (11,12).…”

Section: Cetuximab-induced Skin Exanthema: Improvement By a Reactive mentioning

confidence: 99%

Cetuximab-induced skin exanthema: Improvement by a reactive skin therapy

et al. 2010

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Abstract. More than 80% of patients treated with cetuximab develop an acneiform follicular skin exanthema. Grade 3 exanthema develops in 9-19% of these cases, bearing the risk of cetuximab dose-reduction or cessation. We retrospectively analysed a cohort of 20 patients treated with cetuximab and an in-house reactive skin protocol upon development of an exanthema. The reactive skin protocol was built up as follows: grade 1 exanthema: topical cleansing syndet (dermowas ® ) + topical metronidazole cream (rosiced ® ); grade 2 exanthema: grade 1 treatment + oral minocycline 50 mg twice per day; grade 3 exanthema: grade 2 treatment + topical corticoid (dermatop ® ) + topical nadifloxacin (Nadixa ® ). as soon as a grade 3 had improved to a grade less than or equal to 2, the application of the topical corticoid was ceased. during the initial 12 weeks of therapy with cetuximab, all patients developed a skin exanthema (20/20; 100%). of these, 2 patients (10%) developed a grade 3 exanthema, 10 patients (50%) experienced a grade 2 and 8 patients (40%) a grade 1 exanthema. Time to onset ranged from 1 to 4 weeks, with the average time to onset being 2.8 weeks. applying the reactive skin protocol after the first occurrence of an exanthema, the grade of exanthema was downgraded as follows: no patients (0%) had a persisting grade 3 exanthema, while only 2 patients (10%) experienced a persisting grade 2 exanthema and 8 patients (40%) a persisting grade 1 exanthema. in the majority of cases (10 patients; 50%), the reactive skin protocol completely controlled the exanthema (grade 0). The average time to exanthema reduction by one grade was 9.5 days. no dose reductions of cetuximab were necessary. cetuximab-induced skin exanthema is effectively managed by applying our reactive protocol. The simple protocol is based on a topical cleansing syndet and topical metronidazole and is to be intensified by the addition of oral minocycline, a topical corticoid and topical nadifloxacine, in cases of high-grade exanthema. More comprehensive results are expected from a prospective study with higher patient numbers that is currently being planned. Introductionepidermal growth factor receptor (eGFr) inhibitors are used as highly effective therapies for diverse tumour entities, including colorectal, head and neck, non-small cell lung and pancreatic cancers, among other malignancies (1-5). although eGFr inhibitors, such as cetuximab, are generally well tolerated and do not increase the classical adverse events of chemotherapy, they induce a skin exanthema that occurs in more than 80% of patients (1,4). While the exanthema has an acneiform appearance, its origin is nonetheless follicular (5). This follicular acneiform exanthema presents itself as maculae, papulae or small pustulae occurring on the face, décolleté or back, and may be accompanied by symptoms, such as burning or itching.Time to onset is between 2 and 3 weeks after the first application of the eGFr inhibitor. While the majority of patients develop only mild exanthemas (grades 1 or 2), 9-...

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“…A number of further drugs can also secondarily induce keratolysis over their influence on other pathogenic factors [31]. Benzoyl peroxide and topical and systemic antibiotics primarily exhibit antimicrobial, but also anti-inflammatory activities [32, 33]. Various agents administered in acne treatment exhibit direct or indirect anti-inflammatory activities in addition to their effects on further pathogenic factors of acne.…”

Section: Therapeutic Targets and Acne Drugsmentioning

confidence: 99%

“…Oral antibiotics are indicated for several groups of patients with inflammatory acne (table 3) [33, 38]. They include tetracyclines (tetracyclines, doxycycline, minocycline), erythromycin, clindamycin, and cotrimoxazole (table 4).…”

Section: Systemic Treatmentmentioning

confidence: 99%

Update and Future of Systemic Acne Treatment

2003

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Systemic treatment is required in patients with moderate-to-severe acne, especially when acne scars start to occur. Antibiotics with anti-inflammatory properties, such as tetracyclines (oxytetracycline, tetracycline chloride, doxycycline, minocycline and limecycline) and macrolide antibiotics (erythromycin and azithromycin) are the agents of choice for papulopustular acne, even though the emerging resistant bacterial strains are minimizing their effect, especially regarding erythromycin. Systemic antibiotics should be administered during a period of 8–12 weeks. In severe papulopustular and in nodulocystic/conglobate acne, oral isotretinoin is the treatment of choice. Hormonal treatment represents an alternative regimen in female acne, whereas it is mandatory in resistant, severe pubertal or post-adolescent forms of the disease. Compounds with anti-androgenic properties include estrogens combined with progestins, such as ethinyl estradiol with cyproterone acetate, chlormadinone acetate, desogestrel, drospirenone, levonogestrel, norethindrone acetate, norgestimate, and other anti-androgens directly blocking the androgen receptor (flutamide) or inhibiting androgen activity at various levels, corticosteroids, spironolactone, cimetidine, and ketoconazole. After 3 months of treatment control of seborrhea and acne can be obtained. Low-dose corticosteroids (prednisone, prednisolone, or dexamethasone) are indicated in patients with adrenal hyperandrogenism or acne fulminans. New developments and future trends represent low-dose long-term isotretinoin regimens, new isotretinoin formulations (micronized isotretinoin), isotretinoin metabolites, combination treatments to reduce toxicity, insulin-sensitizing agents, 5α-reductase type 1 inhibitors, antisense oligonucleotide molecules, and, especially, new anti-inflammatory agents, such as lipoxygenase inhibitors.

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Systemic Antibiotics for Acne

Cited by 61 publications

References 50 publications

Synergistic Antibacterial Effects of Chitosan-Caffeic Acid Conjugate against Antibiotic Resistant Acne-Related Bacteria

Synergistic Antibacterial Effects of Chitosan-Caffeic Acid Conjugate against Antibiotic Resistant Acne-Related Bacteria

Cetuximab-induced skin exanthema: Improvement by a reactive skin therapy

Update and Future of Systemic Acne Treatment

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