An Ji Hae, Moon Su Jin, Shin Jung U, Kim Dong Hyun, Yoon Moon Soo, Lee Hee Jung
Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
Department of Medicine, CHA University School of Medicine, Pocheon, Korea.
Ann Dermatol. 2021 Dec;33(6):515-521. doi: 10.5021/ad.2021.33.6.515. Epub 2021 Nov 4.
A rifampicin (RF)-clindamycin (CL) combination therapy is recommended as the first-line treatment for moderate to severe hidradenitis suppurativa (HS). Although the long-term use of RF requires caution due to the possibility of developing resistant bacteria, only a few studies have investigated alternatives for this combination therapy.
To evaluate the efficacy of systemic CL mono-therapy and assess the prevalence and CL resistance of bacterial growth in HS patients.
A total of 53 HS patients treated with CL mono-therapy were included. The efficacy was evaluated by identifying the rate of HS Clinical Response (Hi-SCR) achievers and comparing HS Physician's Global Assessment (HS-PGA) before (W0) and after (W8) the treatment. Purulent material from HS skin lesions was collected on the W0. Bacterial flora and antibiotic sensitivity were determined by bacterial cultures.
Of 53 HS patients, 34 were eligible for evaluation of the efficacy of the therapy. Twenty-one patients (61.76%) achieved Hi-SCR. The mean scoring of HS-PGA had significantly decreased from 3.24 to 2.15 (=0.001). The prevalence of CL resistance was 15.00%. No significant differences in the efficacy of the therapy according to the presence of CL-resistant bacteria on the W0 were observed (=0.906). Adverse events occurred in 26.42% of patients.
Systemic CL mono-therapy may be a safe and useful alternative to RF-CL combination therapy, and no significant difference in the efficacy of the therapy depending on the presence of CL-resistant bacteria was observed.
利福平(RF)-克林霉素(CL)联合疗法被推荐作为中度至重度化脓性汗腺炎(HS)的一线治疗方法。尽管由于可能产生耐药菌,长期使用RF需要谨慎,但只有少数研究探讨了这种联合疗法的替代方案。
评估全身性CL单药治疗的疗效,并评估HS患者细菌生长中CL耐药性的发生率。
共纳入53例接受CL单药治疗的HS患者。通过确定HS临床反应(Hi-SCR)达标率并比较治疗前(W0)和治疗后(W8)的HS医师整体评估(HS-PGA)来评估疗效。在W0时收集HS皮肤病变的脓性物质。通过细菌培养确定细菌菌群和抗生素敏感性。
53例HS患者中,34例符合治疗疗效评估标准。21例患者(61.76%)达到Hi-SCR。HS-PGA的平均评分从3.24显著降至2.15(=0.001)。CL耐药率为15.00%。未观察到根据W0时是否存在CL耐药菌而导致的治疗疗效有显著差异(=0.906)。26.42%的患者发生了不良事件。
全身性CL单药治疗可能是RF-CL联合疗法的一种安全有效的替代方案,且未观察到根据CL耐药菌的存在与否而导致的治疗疗效有显著差异。