Perche Patrick O, Peck Gabrielle M, Robinson Lillian, Grada Ayman, Fleischer Alan B, Feldman Steven R
Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC 27104, USA.
College of Medicine, University of Cincinnati, 3230 Eden Ave., Cincinnati, OH 45267, USA.
Antibiotics (Basel). 2023 Jan 28;12(2):269. doi: 10.3390/antibiotics12020269.
Acne vulgaris is the most common reason for pediatric patients and third most common reason for adult patients to seek care from a dermatologist in the US. However, referring providers may be reluctant to initiate patients on acne treatment or certain prescriptions. We assessed over-the-counter (OTC) and prescription acne (antibiotic and non-antibiotic) treatment rates to characterize differences by patient demographics and provider specialty. The National Ambulatory Medical Care Survey (NAMCS) was analyzed for all acne therapies prescribed for at least 10 unweighted visits between 1993 and 2016 (most recent years available). Prescription rates varied by age, with younger patients more likely to receive a prescription; insurance status, with privately insured patients more likely to receive a prescription; and across and within specialties, with dermatologists more likely to recommend a prescription medication than family medicine and pediatric providers. Among all forms of antibiotics for acne vulgaris, oral minocycline was the most commonly prescribed antibiotic by dermatologists, followed by oral doxycycline. Oral minocycline was also the most common antibiotic prescribed by family physicians, followed by oral doxycycline and oral clindamycin, respectively. Pediatricians appeared to be less likely to prescribe oral antibiotics for acne. The OTC topical antimicrobial benzoyl peroxide was the most utilized drug for acne among pediatricians, and it was also the most commonly recommended OTC drug for acne among dermatologists, family physicians, and pediatricians.
寻常痤疮是美国儿科患者寻求皮肤科医生治疗的最常见原因，也是成年患者寻求皮肤科医生治疗的第三大常见原因。然而，转诊医生可能不愿意让患者开始痤疮治疗或开具某些处方。我们评估了非处方（OTC）和处方痤疮（抗生素和非抗生素）治疗率，以了解患者人口统计学特征和医生专业的差异。对1993年至2016年（可获取的最近年份）期间至少10次未加权就诊所开具的所有痤疮治疗方法进行了全国门诊医疗调查（NAMCS）分析。处方率因年龄而异，年轻患者更有可能获得处方；因保险状况而异，有私人保险的患者更有可能获得处方；并且在不同专业之间以及同一专业内部，皮肤科医生比家庭医学和儿科医生更有可能推荐处方药。在治疗寻常痤疮的所有抗生素中，口服米诺环素是皮肤科医生最常开具的抗生素，其次是口服多西环素。口服米诺环素也是家庭医生最常开具的抗生素，其次分别是口服多西环素和口服克林霉素。儿科医生开具口服抗生素治疗痤疮的可能性似乎较小。非处方外用抗菌剂过氧化苯甲酰是儿科医生治疗痤疮最常用的药物，也是皮肤科医生、家庭医生和儿科医生治疗痤疮最常推荐的非处方药。
