Efficacy of oral antibiotics on acne vulgaris and their effects on quality of life: A multicenter randomized controlled trial using minocycline, roxithromycin and faropenem

Abstract

There are few clinical studies which compare the efficacy and patient satisfaction for oral antibiotics to treat inflammatory acne. To clarify the difference between oral antibiotics, acne patients with moderate to severe inflammatory eruptions were randomized into three groups, and each patient was given minocycline (MINO), roxithromycin (RXM) or faropenem (FRPM) for 4 weeks, followed by 4 weeks of observation without any oral antibiotics. We estimated the reduction rate of inflammatory lesion counts, the scale of Skindex-16 which represents patient quality of life (QOL), and minimum inhibitory concentrations required to inhibit the growth of 90% of Propionibacterium acnes isolated from acne patients (MIC(90) ). In all three groups, inflammatory lesion counts, and emotional and total score of Skindex-16 were significantly improved (P<0.05) after 4 weeks treatment, and these effects were maintained for the following 4 weeks. Dizziness/nausea in two patients (4.1%) of the MINO group and diarrhea in three patients (5.9%) of the FRPM group were observed. There was no significant difference of percentage reduction in inflammatory lesion counts and incident rates of side-effects between these three oral antibiotics. MIC(90) of MINO was 0.25 μg/mL before and after treatment, but MIC(90) of RXM had increased from 0.25 μg/mL to more than 32 μg/mL after treatment. MIC(90) of FRPM was 0.06 μg/mL or less for all strains before and after treatment. Our randomized controlled clinical trial suggested that MINO, RXM and FRPM were efficient to improve inflammatory acne and patient QOL, and there was no significant difference between them.

The Skindex Instruments to Measure the Effects of Skin Disease on Quality of Life

“…Examples of this use include studies of therapies for psoriasis 17,18 , acne vulgaris 19 , and atopic dermatitis 20 .…”

Matrix Metalloproteinases and Minocycline: Therapeutic Avenues for Fragile X Syndrome

“…However, another possibility that must be considered arises from the fact that minocycline also functions as an antibiotic by inhibiting bacterial translation, and a similar function could be predicted to antagonize the effect of losing FMRP translational repression, causing elevated translation [21]. Although this should not be a consideration at the levels of minocycline used in the recent FXS studies (Table 1), which are the same dosages as used for treatment of acne and bacterial infections, such as neurosyphilis [112, 113], it remains a strong possibility to be investigated as potentially FXS patients may be more sensitive toward minocycline treatment than healthy individuals. Significant research into minocycline's effects on eukaryotic ribosomes, especially in FXS, has not been done and must be performed extensively to determine if the minocycline mechanism of action is through its ability to regulate translation.…”

Multicenter randomized controlled trial on combination therapy with 0.1% adapalene gel and oral antibiotics for acne vulgaris: Comparison of the efficacy of adapalene gel alone and in combination with oral faropenem

“…Faropenem, an oral b-lactam penem antibacterial agent, has been approved for treating acne in Japan; it shows excellent efficacy on inflammatory acne. [4][5][6] The effects of faropenem on inflammatory acne are not significantly different from those of mino-cycline, a tetracycline antibiotic, and roxithromycin, a macrolide antibiotic. 4 Faropenem has a highly potent antibacterial activity against Propionibacterium acnes, 4,6 and administration of the agent for 4 weeks does not lead to drug resistance.…”

“…[4][5][6] The effects of faropenem on inflammatory acne are not significantly different from those of mino-cycline, a tetracycline antibiotic, and roxithromycin, a macrolide antibiotic. 4 Faropenem has a highly potent antibacterial activity against Propionibacterium acnes, 4,6 and administration of the agent for 4 weeks does not lead to drug resistance. 4 The present study aimed to determine the effects of combination therapy with adapalene and oral antibiotics and the preferable duration of the therapy.…”