Approaches to limit systemic antibiotic use in acne: Systemic alternatives, emerging topical therapies, dietary modification, and laser and light-based treatments

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:80

Review

Barbieri, John S.¹  Spaccarelli, Natalie¹  Margolis, David J.^1,2  James, William D.¹ 

[1] Univ Penn, Dept Dermatol, Perelman Sch Med, Philadelphia, PA 19104 USA

[2] Univ Penn, Dept Biostat & Epidemiol, Perelman Sch Med, Philadelphia, PA 19104 USA

关键词: acne;    antibiotics;    antibiotic stewardship;    diet;    evidence-based medicine;    guidelines;    isotretinoin;    laser;    spironolactone;   

DOI  :  10.1016/j.jaad.2018.09.055

来源: Elsevier

【 摘 要 】

Acne is one of the most common diseases worldwide and affects; 50 million individuals in the United States. Oral antibiotics are the most common systemic agent prescribed for the treatment of acne. However, their use might be associated with a variety of adverse outcomes including bacterial resistance and disruption of the microbiome. As a result, multiple treatment guidelines call for limiting the use of oral antibiotics in the treatment of acne, although actual prescribing often does not follow these guidelines. In this review, the rationale for concerns regarding the use of oral antibiotics for the management of acne is reviewed. In addition, we will discuss our approach to complying with the intent of the guidelines, with a focus on novel topical agents, dietary modification, laser and light-based modalities, and systemic medications, such as spironolactone, combined oral contraceptives, and oral isotretinoin.

【 授权许可】

Free