Wake Forest University, Baptist Medical Center, Winston-Salem, NC, USA.
G Ital Dermatol Venereol. 2012 Jun;147(3):227-38.
Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit with a multifactorial pathogenesis. Topical and oral antibiotics are a mainstay treatment for inflammatory acne lesions and are widely utilized for all levels of disease severity. Over the past forty years, a gradual increase in antibacterial-resistant strains of Propionibacterium acnes has changed the way practitioners use antibiotics to manage acne. Updated recommendations call for avoiding antibiotic monotherapy and prescribing it in combination with benzoyl peroxide or retinoids. In addition to reducing the risk of developing bacterial resistance, antibiotics prescribed in combination formulations with benzoyl peroxide or retinoids are more efficacious than monotherapy, provide fast therapeutic results, and are associated with greater patient adherence due to the simplification of treatment regimens. Newer management strategies include limiting antibiotic use to the initial 3-6 months of treatment and then switching to topical retinoids for maintenance therapy.
寻常痤疮是一种累及毛囊皮脂腺单位的慢性炎症性疾病，其发病机制具有多因素性。局部和口服抗生素是治疗炎症性痤疮皮损的主要手段，广泛应用于不同严重程度的痤疮。在过去的四十年中，痤疮丙酸杆菌对抗菌药物的耐药菌株逐渐增加，这改变了临床医生使用抗生素治疗痤疮的方式。最新的推荐意见呼吁避免抗生素单药治疗，并将其与过氧化苯甲酰或维 A 酸联合应用。与单药治疗相比，联合应用抗生素与过氧化苯甲酰或维 A 酸的制剂不仅可以降低细菌耐药风险，而且疗效更好，能更快地达到治疗效果，同时由于治疗方案简化，患者的依从性更高。新的管理策略包括将抗生素的使用限制在治疗的最初 3-6 个月，然后转为局部维 A 酸维持治疗。
