Topical antibiotics for acne treatment

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Abstract


Urgency. Acne is a prevalent polymorphous multifactorial inflammatory disease with various clinical forms ranging from the mildest ones (comedonal) to the most severe forms such as phlegmonous, indurative and cystic acne. According to epidemiology studies, the acne incidence rate in general population varies from 85% to 93%; moreover, there is a trend towards the growth in the incidence rate of postpubertal and persistent acne in adults. Acne treatment methods depend on the adequate clinical assessment of the disease severity, character of eruptions, skin type, any concomitant pathologies and patient’s age. Topical therapy is administered to all patients regardless of the disease severity and forms a mandatory part of the therapeutic complex treatment of acne patients. Despite the range of available drugs and treatment methods, researchers keep searching for new drugs and treatment methods for treating acne. Combination acne therapies enjoy keen interest in the world for reasons such as stable treatment results and improved compliance. It is essential that the administration of a combination therapy came along with drugs having a complimentary mechanism of action. Drug combinations have an effect on a large number of pathogenetic factors resulting in acne (excessive follicular hyperkeratosis, propagation of P. аспвв, inflammation). Goal. The goal of this article is a review of literature sources on current aspects of acne topical therapy and examining results of studies of a combination therapy, azelaic acid and clindamycin. Study materials and methods. The project was carried out at the GBOU VPO Kursk State Medical University, Ministry of Health of the Russian Federation. Major results. Both Russian and foreign authors use combination therapies with topical administration of azelaic acid and clindamycin on a broad scale. According to a study conducted in Russia, azelaic acid is a good combination substance for administration with both topical antibiotics (the antibiotic is to be applied to pustules once a day) and adapalene. According to the clinical study results, 15% azelaic acid (Azelic gel) as a part of a combination topical therapy reduces adverse effects observed in the course of a monotherapy with topical retinoids and improves the therapeutic efficacy when combined with antibacterial drugs. Conclusion. The practical experience and different variants of a combination therapy with 15% azelaic acid (Azelic gel) and 1% clindamycin gel (Clindovit) provide dermatologists with an opportunity to treat acne in different groups of patients on an everyday basis with increased efficacy achieving a longer remission of the inflammatory process.

About the authors

L. V. Silina

Kursk State Medical University

Author for correspondence.
Email: noemail@neicon.ru

Russian Federation

E. V. Pismennaya

Kursk regional clinical dermatovenerologic dispensary

Email: evpismennaya@yandex.ru

Russian Federation

M. S. Kolbina

Moscow Health Department clinic № 46

Email: noemail@neicon.ru

Russian Federation

References

  1. Guidelines of care for the management of acne vulgaris.J Am AcadDermatol. 2016 Feb 15. pii: S0190-9622(15)02614-6. doi: 10.1016/j. jaad.2015.12.037
  2. Федеральные клинические рекомендации по ведению больных акне. Российское общество дерматовенерологов и косметологов 2015
  3. Самцов А.В. Акне и акнеформные дерматозы. м, 2009: 287
  4. Isard O., Knol A.C., Aries M.F. et al. Propionibacterium acnes activates the IGF-1/IGF-1R system in the epidermis and induces keratinocyte proliferation // J Invest Dermatol 2011; 131 (1): 59-66
  5. Nagy I., Pivarcsi A., Kis K. et al. Propionibacterium acnes and lipopolysaccharide induce the expression of antimicrobial peptides and proinflammatory cytokines/chemokines in human sebocytes. Microbes Infect 2006; 8 (8): 2195-2205.
  6. Kim J., Ochoa M.T., Krutzik S. et al. Activation of toll-like receptor 2 in acne triggers inflammatory cytokine responses. J Immunol 2002; 169 (3): 1535-1541.
  7. Arancibia S.A., Beltran C.J., Aguirre I.M. et al. Toll-like receptors are key participants in innate immune responses. Biol. Res 2007; 40 (2): 97-112.
  8. Lai Y., Gallo R.L. Toll-like receptors in skin infections and inflammatory diseases. Infect Disord Drug Targets 2008; 8 (3): 144-155.
  9. Webster G.F. Acne vulgaris. BMJ 2002; 325 (7362): 475-479.
  10. Leyden J.J., Del Rosso J.Q., Webster G.F. Clinical considerations in the treatment of acne vulgaris and other inflammatory skin disorders: focus on antibiotic resistance. Cutis 2007; 79 (6Suppl): 9-25.
  11. Harkaway K.S., McGinley K.J., Foglia A.N. et al. Antibiotic resistance patterns in coagulasenegative staphylococci after treatment with topical erythromycin, benzoyl peroxide, and combination therapy. Br J Dermatol 1992; 126 (6): 586-590.
  12. Vowels B.R., Feingold D.S., Sloughfy C. et al. Effects of topical erythromycin on ecology of aerobic cutaneous bacterial flora. Antimicrob Agents Chemother 1996; 40 (11): 2598-2604.
  13. Vowels B.R., Feingold D.S., Sloughfy C. et al. Effects of topical erythromycin on ecology of aerobic cutaneous bacterial flora. Antimicrob Agents Chemother 1996; 40 (11): 2598-2604.
  14. Mills O.Jr., Thornsberry C., Cardin C.W. et al. Bacterial resistance and therapeutic outcome following three months of topical acne therapy with 2% erythromycin gel versus its vehicle. ActaDermVenereol 2002; 82 (4): 260-265
  15. Акне и розацеа. Под ред. проф. Н.Н. Потекаева. м: Бином 2007; 216, ил
  16. Руководство по дермато-косметологии. Под ред. Е.Р. Аравийской, Е.В. Соколовского. СПб: Фолиант 2008; 632: ил
  17. Перламутров Ю.Н., Чижова С.К., Корчевая Т.А., Ольховская К.Б. Сравнительная эффективность и переносимость различных методов терапии акне у женщин. Клин дерматол венерол 2012; 3: 72-77
  18. Thiboutot D. Overview of acne and its treatment. Cutis 2008 Jan; 81 (1 Suppl): 3-7
  19. Аравийская Е.Р., Соколовский Е.В. комбинированные препараты в наружном лечении акне: современные данные. Вестн дерматол венерол 2012; 3: 111-114
  20. Пашинян А.Г. Фармакотерапия акне. Лечащий врач 2006; 9: 18-20
  21. Pazoki-Toroudi H., Nilforoushzadeh M.A., Ajami M., Jaffary F., Aboutaleb N., NassiriKashani M., Firooz A. Combination of azelaic acid 5% and clindamycin 2% for the treatment of acne vulgaris. Cutan Ocul Toxicol 2011; Dec; 30 (4): 286-91
  22. Lookingbill D., Chalker D., Lindholm et al. Treatment of acne with a combination clindamycin/benzoil peroxide gel compared with clindamycin gel, benzoyl peroxide gel and vehicle gel J Am Acad Dermatol 1997; 37: 590-595.
  23. Leyden J.J., Hickman J.G., Jarratt M.T., Stewart D.M., Levy S.F. The efficacy and safety of a combination benzoyl peroxide/clindamycin topical gel compared with benzoyl peroxide alone and a benzoyl peroxide/erythromycin combination product. J Cutan Med Surg 2001 Jan-Feb; 5 (1): 37-42.
  24. Самцов А.В. Топические антибиотики в лечении акне. Вестн дерматол венерол 2011; 1: 84-85
  25. Kuhlman D.S., Callen J.P. A comparison of clindamycin phosphate 1 percent topical lotion and placebo in the treatment of acne vulgaris. Cutis 1986; 38: 203-206
  26. Katsambas A., Towarky A.A., Stratigos J. Topical clindamycin phosphate compared with oral tetracycline in the treatment of acne vulgaris. Br J Dermatol 1987; 116: 387-391
  27. Монахов К.Н., Домбровская Д.К. Комплексная наружная терапия вульгарных угрей. Вестн дерматол венерол 2012; 3: 104-107

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