Center for Dermatology Research, Departments of Dermatology, Wake Forest School of Medicine, Medical Center Boulevard , Winston-Salem, NC 27157-1071 , USA.
J Dermatolog Treat. 2014 Apr;25(2):97-9. doi: 10.3109/09546634.2013.852297.
The aim of this study is to evaluate the frequency of dosing topical antibiotics as monotherapy in the treatment of acne vulgaris, and physician specialty prescribing these medications.
This study is a retrospective review of all visits with a sole diagnosis of acne vulgaris (ICD-9-CM code 706.1) found on the National Ambulatory Medical Care Survey (NAMCS) in 1993-2010. We recorded the number of visits surveyed where acne vulgaris was the sole diagnosis, number of visits where topical antibiotics were the only treatment prescribed, and the specialty of physician in each encounter.
Topical erythromycin or clindamycin were the sole medication prescribed in 0.81% of the visits recorded, with 60% of these prescriptions arising from dermatologists and 40% from non-dermatologists. The trend of prescribing topical antibiotic monotherapy is declining (p < 0.001) over the 18-year study period.
The development of resistance of Propionibacterium acnes to topical antibiotic regimens has led to the need to re-evaluate the use of topical antibiotics in the treatment of acne vulgaris. While the rate of topical antibiotic monotherapy is declining, their use should be reserved for situations where the direct need for antibiotics arises. If a clinician feels that antibiotics are a necessary component to acne therapy, they should be used as part of a combination regimen.
本研究旨在评估将局部抗生素作为单一疗法治疗寻常痤疮的频率，以及医师专门开这些药物的情况。
本研究是对 1993 年至 2010 年国家门诊医疗调查（NAMCS）中所有单纯诊断为寻常痤疮（ICD-9-CM 代码 706.1）的就诊情况进行的回顾性分析。我们记录了调查中记录的单纯诊断为寻常痤疮的就诊次数、仅开局部抗生素治疗的就诊次数以及每次就诊的医师专业。
在记录的就诊中，单独使用红霉素或克林霉素的比例为 0.81%，其中 60%来自皮肤科医生，40%来自非皮肤科医生。在 18 年的研究期间，单独使用局部抗生素治疗的趋势呈下降趋势（p < 0.001）。
痤疮丙酸杆菌对局部抗生素方案的耐药性发展导致需要重新评估局部抗生素在治疗寻常痤疮中的应用。虽然局部抗生素单药治疗的比例正在下降，但应将其保留用于直接需要抗生素的情况。如果临床医生认为抗生素是痤疮治疗的必要组成部分，则应将其作为联合治疗方案的一部分使用。
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