Efficacy of ertapenem in severe hidradenitis suppurativa: a pilot study in a cohort of 30 consecutive patients
| Autor: | Olivier Join-Lambert, S. Duchatelet, Vincent Jullien, Maïa Delage, Jean-Philippe Jais, Olivier Lortholary, Hélène Guet-Revillet, Alain Hovnanian, Hélène Coignard-Biehler, Xavier Nassif, Aude Nassif, Sylvain Poirée |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Ertapenem Male 0301 basic medicine Microbiology (medical) medicine.medical_specialty Adolescent medicine.drug_class Antibiotics Pilot Projects beta-Lactams Severity of Illness Index Young Adult 030207 dermatology & venereal diseases 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine Severity of illness medicine Humans Pharmacology (medical) Hidradenitis suppurativa Young adult Adverse effect Retrospective Studies Pharmacology business.industry Retrospective cohort study Middle Aged medicine.disease Combined Modality Therapy Anti-Bacterial Agents Hidradenitis Suppurativa Surgery Treatment Outcome 030104 developmental biology Infectious Diseases chemistry Surgical Procedures Operative Cohort Female business |
| Zdroj: | Journal of Antimicrobial Chemotherapy. 71:513-520 |
| ISSN: | 1460-2091 0305-7453 |
| DOI: | 10.1093/jac/dkv361 |
| Popis: | OBJECTIVES Hidradenitis suppurativa (HS) is an inflammatory skin disease typically localized in the axillae and inguinal and perineal areas. In the absence of standardized medical treatment, severe HS patients present chronic suppurative lesions with polymicrobial anaerobic abscesses. Wide surgery is the cornerstone treatment of severe HS, but surgical indications are limited by the extent of lesions. Intravenous broad-spectrum antibiotics may help control HS, but their efficacy is not documented. This study was designed to assess the efficacy of a 6 week course of ertapenem (1 g daily) and of antibiotic consolidation treatments for 6 months (M6) in severe HS. PATIENTS AND METHODS Thirty consecutive patients with severe HS were retrospectively included in this study. The clinical severity of HS was assessed using the Sartorius score, which takes into account the number and severity of lesions. RESULTS The median (IQR) Sartorius score dropped from 49.5 (28-62) at baseline to 19.0 (12-28) after ertapenem (P < 10(-4)). Five patients were lost to follow-up thereafter. At M6 the Sartorius score further decreased for the 16 patients who received continuous consolidation treatments, since 59% of HS areas reached clinical remission at M6 (i.e. absence of any inflammatory symptoms, P < 10(-4)). Nine patients interrupted or received intermittent consolidation treatments due to poor observance or irregular follow-up. Their Sartorius score stopped improving or returned to baseline. No major adverse event occurred. CONCLUSIONS Ertapenem can dramatically improve severe HS. Consolidation treatments are needed to further improve HS and are mandatory to prevent relapses. Combined with surgery, optimized antibiotic treatments may be promising in severe HS. |
| Databáze: | OpenAIRE |
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