Oral Antibacterial Therapy for Acne Vulgaris: An Evidence-Based Review
| Autor: | Seth J. Orlow, Amanda Bienenfeld, Arielle R. Nagler |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class Antibiotics Administration Oral Guidelines as Topic Minocycline Dermatology Placebo 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Meta-Analysis as Topic Acne Vulgaris medicine Humans 030212 general & internal medicine Dosing Acne Randomized Controlled Trials as Topic Clinical Trials as Topic Evidence-Based Medicine business.industry General Medicine medicine.disease Trimethoprim Anti-Bacterial Agents Clinical trial Treatment Outcome Systematic review Tetracyclines Doxycycline Practice Guidelines as Topic business medicine.drug |
| Zdroj: | American Journal of Clinical Dermatology. 18:469-490 |
| ISSN: | 1179-1888 1175-0561 |
| Popis: | To some degree, acne vulgaris affects nearly every individual worldwide. Oral antibiotic therapy is routinely prescribed for the treatment of moderate to severe inflammatory acne; however, long-term use of oral antibiotics for acne may have unintended consequences. The aim of this study was to provide a systematic evaluation of the scientific evidence on the efficacy and appropriate use of oral antibiotics in the treatment of acne. A systematic search of MEDLINE was conducted to identify randomized controlled clinical trials, systematic reviews, and meta-analyses evaluating the efficacy of oral antibiotics for acne. Overall, 41 articles that examined oral antibiotics compared with placebo, another oral therapy, topical therapy, alternate dose, or duration were included in this study. Tetracyclines, macrolides, and trimethoprim/sulfamethoxazole are effective and safe in the treatment of moderate to severe inflammatory acne. Superior efficacy of one type or class of antibiotic could not be determined, therefore the choice of antibiotic is generally based on the side-effect profile. Although different dosing regimens have been studied, there is a lack of standardized comparator trials to determine optimal dosing and duration of each oral antibiotic used in acne. The combination of oral antibiotics with a topical therapy is superior to oral antibiotics alone. This article provides a systematic evaluation of the scientific evidence of the efficacy of oral antibiotics for acne. Due to heterogeneity in the design of the trials, there is insufficient evidence to support one type, dose, or duration of oral antibiotic over another in terms of efficacy; however, due to increasing resistance to antibiotics, dermatologists should heed consensus guidelines for their appropriate use. |
| Databáze: | OpenAIRE |
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