Department of Dermatology and Venereology, Istanbul Medeniyet University, School of Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey.
Department of Family Medicine, Istanbul Medeniyet University, School of Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey.
Dermatol Ther. 2020 Nov;33(6):e13973. doi: 10.1111/dth.13973. Epub 2020 Jul 25.
Acne vulgaris (AV) is a common skin disease that is treated both with dermatologists and family physicians (FPs) with different strategies. To assess the antibiotics that are frequently preferred in AV treatment, and the differences between the FPs and dermatologists in treatment were investigated. The physicians were informed about the study, and sent over the internet a multiple-choice questionnaire that consists of 29 questions in total. Afterwards, the answers provided were compared. 201 dermatologists and 147 FPs participated in the study. Dermatologists were found to have preferred topical erythromycin, nadifloxacin, clindamycin, and tetracycline, and systematically doxycycline and azithromycin in adult patients, whereas the FPs were found to have preferred mupirocin, fusidic acid (FA), and oxytetracycline, and systematically tetracycline. Dermatologists were found to have recommended topical clindamycin and erythromycin in pregnant/breastfeeding AV patients, whereas the FPs were found to have recommended FA. Dermatologists were found to have continued the antibiotics for 8 to 12 weeks, whereas the FPs were found to have continued for 1 to 4 weeks. The dermatologists preferred systemic antibiotics in cases with back involvement, moderate to severe AV, and that the FPs preferred them in severe AV. The dermatologists considered that the use of antibiotics alone or long-term were important factors causing antibiotic resistance. There were significant differences between the approaches of dermatologists and FPs to AV treatment. FPs were found to have insufficient information about prevention of antibiotic resistance. Therefore, we think that the continuous training of FPs on dermatology will be beneficial.
寻常痤疮（AV）是一种常见的皮肤病，皮肤科医生和家庭医生（FPs）都采用不同的策略进行治疗。为了评估在 AV 治疗中经常被优先选用的抗生素，并调查 FPs 和皮肤科医生在治疗中的差异，我们对医生进行了研究，并通过互联网向他们发送了一份包含 29 个问题的多项选择问卷。之后，对提供的答案进行了比较。共有 201 名皮肤科医生和 147 名 FPs 参与了这项研究。结果发现，皮肤科医生更倾向于为成年患者开局部用红霉素、那氟沙星、克林霉素和四环素，并系统地开多西环素和阿奇霉素，而 FPs 则更倾向于开莫匹罗星、夫西地酸（FA）和四环素，并系统地开四环素。皮肤科医生建议在妊娠/哺乳期 AV 患者中使用局部克林霉素和红霉素，而 FPs 则建议使用 FA。皮肤科医生发现，他们会继续使用抗生素 8 到 12 周，而 FPs 则会继续使用 1 到 4 周。皮肤科医生在涉及背部、中重度 AV 的情况下以及 FPs 在重度 AV 的情况下更倾向于使用全身性抗生素。皮肤科医生认为，单独使用抗生素或长期使用抗生素是导致抗生素耐药性的重要因素。皮肤科医生和 FPs 对 AV 治疗的方法存在显著差异。FPs 对预防抗生素耐药性的了解不足。因此，我们认为对 FPs 进行持续的皮肤科培训将是有益的。
