Turowski Cheryl Bansal, James William D
Department of Dermatology, Drexel University College of Medicine, Philadelphia, PA, USA.
Adv Dermatol. 2007;23:155-63. doi: 10.1016/j.yadr.2007.07.003.
In situations where acne has proved resistant to other systemic agents or they are not indicated and isotretinoin is not desired by patients, the authors find amoxicillin, TMP-SMX, and spironolactone, alone or in combination, useful alternatives. In women who have acne, spironolactone can be used, and in patients who have sulfa allergy, amoxicillin can be used. It is important to continue alternate topical therapy along with these interventions to augment the improvement and to assist in the eventual discontinuance of oral medication. All of the authors' patients were using topical therapy concomitantly and, although this may have contributed to improvement, the authors believe the addition of amoxicillin, TMP-SMX, or spironolactone contributes to the majority of improvement. Tetrospective chart analysis provides supportive data for amoxicillin, TMP-SMX, and spironolactone in the treatment of refractory acne vulgaris.
在痤疮对其他全身性药物耐药或不适用且患者不希望使用异维A酸的情况下，作者发现阿莫西林、复方新诺明和螺内酯单独使用或联合使用是有用的替代药物。对于患有痤疮的女性，可以使用螺内酯；对于对磺胺类药物过敏的患者，可以使用阿莫西林。在进行这些干预的同时继续交替使用局部治疗以增强改善效果并帮助最终停用口服药物非常重要。作者的所有患者都同时使用局部治疗，虽然这可能有助于改善，但作者认为添加阿莫西林、复方新诺明或螺内酯是改善的主要原因。回顾性图表分析为阿莫西林、复方新诺明和螺内酯治疗难治性寻常痤疮提供了支持性数据。
