Department of Dermatology, Center for Dermatology Research, Wake Forest University School of Medicine, Winston-Salem, NC, USA;
Clin Cosmet Investig Dermatol. 2011;4:79-92. doi: 10.2147/CCID.S13873. Epub 2011 Jul 1.
Acne vulgaris is a chronic disease with several pathogenic factors. Multiple medications are typically used that can lead to nonadherence and treatment failure. Combination medications target multiple pathways of acne formation and may offer therapeutic benefit.
To explore the efficacy and tolerability of combination retinoid plus antimicrobial treatments in acne vulgaris.
A PubMed and Google search was conducted for combination therapies of clindamycin and tretinoin, with secondary analysis of related citations and references. Similar searches were completed for the combination medications of benzoyl peroxide plus clindamycin or erythromycin, and for the combination therapy of adapalene and benzoyl peroxide.
Combination clindamycin phosphate and tretinoin gel was found to be more efficacious than monotherapy of either drug or its vehicle for acne, including inflammatory acne, and has a greater onset of action than either drug alone. Clindamycin phosphate and tretinoin gel was well-tolerated, and adherence to its use exceeded that of using both medications in separate formulations. Benzoyl peroxide-containing combination medications with clindamycin or erythromycin were both more effective in the treatment of acne than either drug alone. Both medications were well-tolerated, with dry skin being the most common adverse effect.
Combination medications have superior efficacy and adherence, and have a similar tolerability profile compared with monotherapy of its components. Several studies have found antibiotic-containing combination products with a retinoid effective for acne. The use of antibiotic-containing combination medications for acne can lead to bacterial resistance. Due to this potential for bacterial resistance, benzoyl peroxide treatments are also recommended in combination with a retinoid.
寻常痤疮是一种具有多种发病因素的慢性疾病。通常会使用多种药物，但这可能导致患者不遵医嘱和治疗失败。联合用药针对痤疮形成的多个途径，可能具有治疗益处。
探讨联合使用维 A 酸类药物和抗菌药物治疗寻常痤疮的疗效和耐受性。
在 PubMed 和 Google 上搜索克林霉素和维 A 酸联合治疗的相关研究，并对相关引文和参考文献进行二次分析。对过氧化苯甲酰与克林霉素或红霉素联合用药的相关研究以及他扎罗汀与过氧化苯甲酰联合治疗的相关研究进行了类似的搜索。
发现克林霉素磷酸酯和维 A 酸凝胶联合用药治疗痤疮，包括炎症性痤疮，比单独使用任一药物或其赋形剂更为有效，且起效更快。克林霉素磷酸酯和维 A 酸凝胶具有良好的耐受性，其使用依从性高于分别使用两种药物。与单独使用克林霉素或红霉素相比，含有过氧化苯甲酰的联合用药在治疗痤疮方面更有效。两种药物均具有良好的耐受性，最常见的不良反应是皮肤干燥。
与单一用药相比，联合用药具有更好的疗效和更高的用药依从性，且具有相似的耐受性。一些研究发现含有维 A 酸的抗生素联合用药对痤疮有效。由于存在细菌耐药的风险，因此也推荐将过氧化苯甲酰与维 A 酸联合用于痤疮的治疗。
