About local administration of antibacterial drugs for acne therapy

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The review summarizes and systematizes data accumulated in the world research literature, which are related to the role of P. acnes in the pathogenesis of acne, its microbiology and antibacterial resistance; it also examines antibacterial drugs for the external therapy of acne and recommendations for their use.


  1. Musumeci M.L., Schlecht K., West D.P., West L.E., Innocenzi D., Micali G. Topical treatment of acne vulgaris. Giornale Italiano di Dermatologia e Venereologia 2005; 140: 713-22.
  2. Gollnick H., Cunliffe W., Berson D., Dreno B., Finlay A., Leyden J.J., et al. Management of acne: a report from a Global Alliance to Improve Outcomes in Acne. J Am Acad Dermatol 2003; 49(1 Suppl): S1-37.
  3. Collier C.N., Harper J.C., Cafardi J.A., Cantrell W.C., Wang W., Foster K.W., et al. The prevalence of acne in adults 20 years and older. J Am Acad Dermatol 2008; 58: 56-9.
  4. Poli F., Pernet A.M., Verschoore M. Epidemiological study on adult acne. J Am Acad Dermatol 2007; 56: AB13.
  5. Till A.E., Goulden V., Cunliffe W.J., Holland K.T. The cutaneous microflora of adolescent, persistent and late-onset acne patients does not differ. Br J Dermatol 2000; 142: 885-92.
  6. Адаскевич В.Л. Акне вульгарные и розовые. НГМА, 2003.
  7. Фицпатрик Т., Джонсон Р., Вульф К. и др. Дерматология. Атлас-справочник. М.: Практика, 1999: 3-11.
  8. Jappe U., Igham E., Henwood J., Holland K.T. Propionibacterium acne and inflammation in acne: P. acnes has T-cell mitogenic activity. Br J Dermatol 2002; 146: 202-9.
  9. Webster G.F., Graber E.M. Antibiotic treatment for acne vulgaris. Semin Cutan Med Surg 2008; 27(3): 183-7.
  10. Cogen A.L., Nizet V., Gallo R.L. Skin microbiota: a source of disease or defence- Br J Dermatol 2008; 158: 442-55.
  11. Cove J.H., Cunliffe W.J., Holland K.T. Acne vulgaris: is the bacterial population size significant- Br J Dermatol 1980; 102: 277-80.
  12. Thiboutot D., Gollnick H., Bettoli V., Dréno B., Kang S., Leyden J.J., et al. New insights into the management of acne: an update from the Global Alliance to Improve Outcomes in Acne group. J Am Acad Dermatol 2009; 60(5 Suppl): S1-50.
  13. Bek-Thomsen M., Lomholt H.B., Kilian M. Acne is not associated with yet-uncultured bacteria. J Clin Microbiol 2008; 46(10): 3355-60.
  14. Coenye T., Peeters E., Nelis HJ. Biofilm formation by Propionibacterium acnes is associated with increased resistance to antimicrobial agents and increased production of putative virulence factors. Res Microbiol 2007; 158(4): 386-92.
  15. Bruggemann H., Henne A., Hoster F., Liesegang H., Wiezer A., Strittmatter A., et al. The complete genome sequence of Propionibacterium acnes, a commensal of human skin. Science 2004; 305(5684): 671-3.
  16. Burkhart C.G., Burkhart C.N. Expanding the microcomedone theory and acne therapeutics: Propionibacterium acnes biofilm produces biological glue that holds corneocytes together to form plug. J Am Acad Dermatol 2007; 57(4): 722-4.
  17. Karvonen S.L., Rasanen L., Cunliffe W.J., Holland K.T., Karvonen J., Reunala T. Delayed hypersensitivity to Propionibacterium acnes in patients with severe nodular acne and acne fulminans. Dermatology 1994; 189: 344-9.
  18. Puhvel S.M., Amirian D., Weintraub J., Reisner R.M. Lymphocyte transformation in subjects with nodulocystic acne. Br J Dermatol 1977; 97: 205-11.
  19. Nakatsuji T., Kao M.C., Fang J.Y., Zouboulis C.C., Zhang L., Gallo R.L., et al. Antimicrobial property of lauric acid against Propionibacterium acnes: its therapeutic potential for inflammatory acne vulgaris. J Invest Dermatol 2009; 129(10): 2480-8.
  20. Kim J., Ochoa M.T., Krutzik S.R., Takeuchi O., Uematsu S., Legaspi A.J., et al. Activation of toll-like receptor 2 in acne triggers inflammatory cytokine responses. J Immunol 2002; 169: 1535-41.
  21. Jugeau S., Tenaud I., Knol A.C., Jarrousse V., Quereux G., Khammari A., et al. Induction of toll-like receptors by Propionibacterium acnes. Br J Dermatol 2005; 153: 1105-13.
  22. Kang S., Cho S., Chung J.H., Hammerberg C., Fisher G.J., Voorhees J.J. Inflammation and extracellular matrix degradation mediated by activated transcription factors nuclear factor-kappaB and activator protein-1 in inflammatory acne lesions in vivo. Am J Pathol 2005; 166: 1691-9.
  23. Leyden J.J. The evolving role of Propionibacterium acnes in acne. Semin Cutan Med Surg 2001; 20(3): 139-43.
  24. Кутасевич Я.Ф., Маштакова И.А., Багмет А.Н., Шаповалова О.В. Микробиоценоз кожи у больных угревой болезнью и пути его коррекции. Украiнський журнал дерматол., венерол., косметол. 2003; 1: 43-7.
  25. Определение чувствительности микроорганизмов к антибактериальным препаратам. Методические указания. МУК 4.2.1890-04 от 04.03.2004.
  26. M11-A7 Methods for Antimicrobial Susceptibility Testing of Anaerobic Bacteria. CLSI Approved Standard. Seventh Edition, 2007.
  27. European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters, Version 1.0. December 2009.
  28. Simpson N. Antibiotics in acne: time for a rethink. Br J Dermatol 2001; 144(2): 225-7.
  29. Holland K.T., Roberts C.D. A technique for sampling micro-organisms from the pilo-sebaceous ducts. J Appl Bacteriol 1974; 37(3): 289-96.
  30. Mills O.H. Jr., Kligman A.M. The follicular biopsy. Dermatologica 1983; 167(2): 57-63.
  31. Leening J.P., Holland K.T., Cuncliffe W.J. The microbial colonization of inflamed acne vulgaris lesions. Br J Dermatol 1988; 118: 203-8.
  32. Потекаев Н.Н., Шугинина Е.А., Анфимова Н.А. Состав микрофлоры в элементах угревой сыпи и эффективность наружной антибактериальной терапии больных акне. Клин. дерматол. и венерол. 2006; 2: 80-2.
  33. Рахманова С.Н., Юцковский А.Д., Накорякова Л.Ф. Чувствительность микрофлоры кожи к антибиотикам у пациентов с угревой болезнью. Тихоокеанский медицинский журнал 2009; 1: 92-4.
  34. Crawford W.W., Crawford I.P., Stoughton R.B., Cornell R.C. Laboratory induction and clinical occurence of combined clindamycin and erythromycin resistance in corynebacterium acnes. J Invest Dermatol 1979; 72: 187-90.
  35. Eadya E.A., Gloorb M., Leyden J.J. Propionibacterium acnes Resistance: A Worldwide Problem. Dermatology 2003; 206: 54-6.
  36. Eady E.A. Bacterial resistance in acne. Dermatology 1998; 196: 59-66.
  37. Ross J.I., Snelling A.M., Carnegie E., Coates P., Cunliffe W.J., Bettoli V., et al. Antibiotic-resistant acne: lessons from Europe. Br J Dermatol 2003; 148: 467-78.
  38. Dréno B., Bettoli V., Ochsendorf F., Layton A., Mobacken H., Degreef H., European Expert Group on Oral Antibiotics in Acne. European recommendations on the use of oral antibiotics for acne. Eur J Dermatol 2004; 14(6): 391-9.
  39. Oprica C., Nord CE, ESCMID Study Group on Antimicrobial Resistance in Anaerobic Bacteria. European surveillance study on the antibiotic susceptibility of Propionibacterium acnes. Clin Microbiol Infect 2005; 11(3): 204-13.
  40. Eady E.A., Jones C.E., Tipper J.L., Cove J.H., Cunliffe W.J., Layton A.M. Antibiotic resistant propionibacteria in acne: need for policies to modify antibiotic usage. BMJ 1993; 306(6877): 555-6.
  41. Sugita T., Miyamoto M., Tsuboi R., Takatori K., Ikeda R., Nishikawa A. In vitro activities of azole antifungal agents against Propionibacterium acnes isolated from patients with acne vulgaris. Biol Pharm Bull 2010; 33(1): 125-7.
  42. Ishida N., Nakaminami H., Noguchi N., Kurokawa I., Nishijima S., Sasatsu M. Antimicrobial susceptibilities of Propionibacterium acnes isolated from patients with acne vulgaris. Microbiol Immunol 2008; 52(12): 621-4.
  43. Coates P., Vyakrnam S., Eady E.A., Jones C.E., Cove J.H., Cunliffe W.J. Prevalence of antibiotic-resistant propionibacteria on the skin of acne patients: 10-year surveillance data and snapshot distribution study. Br J Dermatol 2002; 146(5): 840-8.
  44. Tan H.H. Topical antibacterial treatments for acne vulgaris : comparative review and guide to selection. Am J Clin Dermatol 2004; 5(2): 79-84.
  45. Nord C.E., Oprica C. Antibiotic resistance in Propionibacterium acnes. Microbiological and clinical aspects. Anaerobe 2006; 12(5-6): 207-10.
  46. Eady E.A., Cove J.H., Layton A.M. Is antibiotic resistance in cutaneous propionibacteria clinically relevant- Implications of resistance for acne patients and prescribers. Am J Clin Dermatol 2003; 4: 813-31.
  47. Eady E.A., Cove J.H., Holland K.T., Cunliffe W.J. Erythromycin resistant propionibacteria in antibiotic treated acne patients: association with therapeutic failure. Br J Dermatol 1989; 121: 51-7.
  48. Ozolins M., Eady E.A., Avery A., Cunliffe W.J., O'Neill C., Simpson N.B., et al. Randomised controlled multiple treatment comparison to provide a cost-effectiveness rationale for the selection of antimicrobial therapy in acne. Health Technol Assess 2005; 9(1): iii-212.
  49. Leyden J.J. Antibiotic resistance in the topical treatment of acne vulgaris. Cutis 2004;73(6 Suppl): 6-10.
  50. Dreno B. Topical antibacterial therapy for acne vulgaris. Drugs 2004; 64(21): 2389-97.
  51. Cunliffe W.J., Holland K.T., Bojar R., Levy S.F. A randomized, double-blind comparison of a clindamycin phosphate/benzoyl peroxide gel formulation and a matching clindamycin gel with respect to microbiologic activity and clinical efficacy in the topical treatment of acne vulgaris. Clin Ther 2002; 24(7): 1117-33.
  52. Habbema L., Koopmans B., Menke H.E., Doornweerd S., De Boulle K. A 4% erythromycin and zinc combination (Zineryt) versus 2erythromycin (Eryderm) in acne vulgaris: a randomized, doubleblind comparative study. Br J Dermatol 1989; 121(4): 497-502.
  53. Jarrousse V., Castex-Rizzi N., Khammari A., Charveron M., Dréno B. Zinc salts inhibit in vitro Toll-like receptor 2 surface expression by keratinocytes. Eur J Dermatol 2007; 17(6): 492-6.
  54. Weller R. Nitric oxide - a newly discovered chemical transmitter in human skin. Br J Dermatol 1997; 137: 665-72.
  55. Yamaoka J., Kume T., Akaike A., Miyachi Y. Suppressive effect of zinc ion on iNOS expression induced by interferon-gamma or tumor necrosis factor-alpha in murine keratinocytes. J Dermatol Sci 2000; 23(1): 27-35.
  56. Marone G., Columo A., De Paulis R., et al. Physiological concentrations of zinc inhibit the release of histamine from human basophils and lung mast cells. Agents Actions 1986; 18: 103-6.
  57. Marone G., Findlay S.R., Lichtenstein L.M. Modulation of histamine release from human basophils in vitro in physiological concentrations of zinc. J Pharmacol Exp Ther 1981; 217: 292-8.
  58. Mousli M., Gies J.P., Bertrand C., et al. The sensitivity to Zn2discriminates between typical and atypical mast cells. Agents Actions 1990; 30: 102-5.
  59. Dreno B., Foulc P., Reynaud A., Moyse D., Habert H., Richet H. Effect of zinc gluconate on propionibacterium acnes resistance to erythromycin in patients with inflammatory acne: in vitro and in vivo study. Eur J Dermatol 2005; 15(3): 152-5.
  60. Holland K.T., Bojar R.A., Cunliffe W.J., Cutcliffe A.G., Eady E.A., Farooq L., et al. The effect of zinc and erythromycin on the growth of erythromycin-resistant and erythromycin-sensitive isolates of Propionibacterium acnes: an in-vitro study. Br J Dermatol 1992; 126(5): 505-9.
  61. Strömberg H., Ågren M.S. Topical zinc oxide treatment improves arterial and venous leg ulcers. Br J Dermatol 1984; 111: 461-8.
  62. Tenegrup I., et al. The effect of zinc and occlusion on the healing of open wounds. In: Mills C.F., Bremner I., Chester J.K., editors. Proceedings of the Fifth International Symposium on Trace Elecments in Man and Animals. Cambridge (UK): Commonwealth Agricultural Bureau; 1985. p. 87-9.
  63. Rittenhouse T. The management of lower-extremity ulcers with zincsaline wet dressings versus normal saline wet dressings. Adv Ther 1996; 13: 88-94.
  64. Sugimoto Y., Lopez-Solache I., Labrie F., et al. Cations inhibit specifically type I 5ƒ-reductase found in human skin. J Invest Dermatol 1995; 104: 775-8.
  65. Stamatiadis D., Bulteau-Portois M.C., Mowszowicz L. Inhibition of 5ƒ-reductase activity in human skin by zinc and azelaic acid. Br J Dermatol 1988; 119: 627-32.
  66. Demetree J.W., Safer L.F., Artis W.M. The effect of zinc on sebum secretion rate. Arch Derm Venereol 1980; 60: 166-9.
  67. Schachner L., Pestana A., Kittles C. A clinical trial comparing the safety and efficacy of a topical erythromycin-zinc formulation with a topical clindamycin formulation. J Am Acad Dermatol 1990; 22 (3): 489-95.
  68. Feucht C.L., Allen B.S., Chalker D.K., et al. Topical erythromycin with zinc in acne: a double-blind controlled study. J Am Acad Dermatol 1980; 3: 483-91.
  69. Stainforth J., MacDonald-Hull S.P., Papworth-Smith J.W., et al. A single-blind comparison of topical erythromycin/zinc lotion and oral minocycline in the treatment of acne vulgaris. J Dermatolog Treat 1993; 4:119-22.
  70. Piérard-Franchimont C., Goffin V., Visser J.N., Jacoby H., Piérard G.E. A double-blind controlled evaluation of the sebosuppressive activity of topical erythromycin-zinc complex. Eur J Clin Pharmacol 1995; 49(1-2): 57-60.

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