Approaches to limit systemic antibiotic use in acne: Systemic alternatives, emerging topical therapies, dietary modification, and laser and light-based treatments - 14/01/19
Abstract |
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.
Le texte complet de cet article est disponible en PDF.Key words : acne, antibiotics, antibiotic stewardship, diet, evidence-based medicine, guidelines, isotretinoin, laser, spironolactone
Abbreviations used : COC, HGLD, IGF-1, IPL, LGLD, PDT, PDL, SCD1
Plan
Drs Barbieri and Spaccarelli contributed equally to this work. |
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Funding sources: Dr Barbieri is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under award number T32-AR-007465 and receives partial salary support through a Pfizer Fellowship grant to the Trustees of the University of Pennsylvania. |
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Conflicts of interest: None disclosed. |
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Reprints not available from the authors. |
Vol 80 - N° 2
P. 538-549 - février 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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