Oprica Cristina, Emtestam Lennart, Hagströmer Lena, Nord Carl Erik
Department of Medicine, Division of Dermatology and Venereology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
Acta Derm Venereol. 2007;87(3):246-54. doi: 10.2340/00015555-0211.
The aim of this study was to compare the clinical and microbiological effect on Propionibacterium acnes of oral tetracycline plus topical adapalene vs. oral isotretinoin in moderate to severe acne vulgaris. Male and female acne patients with moderate or severe inflammatory disease were enrolled and assigned randomly to 6 months of treatment with oral tetracycline hydrochloride plus topical adapalene, or oral isotretinoin, in a controlled, open study. After cessation of oral treatment the antibiotic-treated group received topical adapalene for the 2-month follow-up period. Clinical and microbiological assessments were performed. Skin samples for microbial identification and quantification were taken at baseline, after 2, 4 and 6 months of treatment, and 2 months after cessation of treatment. Patients treated with isotretinoin showed prolonged significant remission compared with the other group. The density of resistant propionibacteria did not change significantly in any of the groups and there was no correlation between resistant P. acnes and the clinical response in any of the regions investigated. Antibiotic treatment was found to be a good alternative to isotretinoin, regardless of the presence of antibiotic-resistant P. acnes, although isotretinoin had a better effect, with prolonged remission after treatment.
本研究旨在比较口服四环素联合外用阿达帕林与口服异维A酸治疗中度至重度寻常痤疮对痤疮丙酸杆菌的临床及微生物学影响。纳入患有中度或重度炎症性疾病的男性和女性痤疮患者，在一项对照、开放研究中，将其随机分配接受为期6个月的口服盐酸四环素联合外用阿达帕林治疗或口服异维A酸治疗。口服治疗结束后，抗生素治疗组在2个月的随访期内接受外用阿达帕林治疗。进行了临床和微生物学评估。在基线、治疗2、4和6个月后以及治疗停止2个月后采集皮肤样本用于微生物鉴定和定量。与另一组相比，接受异维A酸治疗的患者显示出显著延长的缓解期。在任何一组中，耐药丙酸杆菌的密度均未显著变化，并且在任何研究区域中，耐药痤疮丙酸杆菌与临床反应之间均无相关性。发现抗生素治疗是异维A酸的良好替代方案，无论是否存在耐药痤疮丙酸杆菌，尽管异维A酸效果更好，治疗后缓解期延长。
