Oral Antibacterial Therapy for Acne Vulgaris: An Evidence-Based Review

被引:63
作者
Bienenfeld, Amanda [1 ]
Nagler, Arielle R. [2 ]
Orlow, Seth J. [2 ]
机构
[1] NYU, Sch Med, New York, NY USA
[2] NYU, Sch Med, Ronald O Perelman Dept Dermatol, 240 East 38th St,11th Floor, New York, NY 10016 USA
关键词
SUBANTIMICROBIAL-DOSE DOXYCYCLINE; RANDOMIZED CONTROLLED-TRIAL; MODERATELY SEVERE ACNE; DOUBLE-BLIND; COMBINATION THERAPY; PROPIONIBACTERIUM-ACNES; TOPICAL CLINDAMYCIN; ANTIBIOTIC-THERAPY; RETROSPECTIVE ANALYSIS; INFLAMMATORY ACNE;
D O I
10.1007/s40257-017-0267-z
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Background 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. Objective 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. Methods 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. Results 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. Conclusion 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.
引用
收藏
页码:469 / 490
页数:22
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