Topical acne treatments in Europe and the issue of antimicrobial resistance

Abstract

Acne vulgaris (acne) is a chronic inflammatory disease of the sebaceous gland, characterized by follicular hyperkeratinization, excessive colonization by Propionibacterium acnes (P. acnes) as well as immune reactions and inflammation. Despite an armamentarium of topical treatments available including benzoyl peroxide, retinoids and azelaic acid, topical antibiotics in monotherapies, especially erythromycin and clindamycin, are still used in Europe to treat acne. This intensive use led to antimicrobial-resistant P. acnes and staphylococci strains becoming one of the main health issues worldwide. This is an update on the current topical acne treatments available in Europe, their mechanism of action, their potential to induce antimicrobial resistance and their clinical efficacy and safety.

A consensus‐based practical and daily guide for the treatment of acne patients

“…Benzoyl peroxide (BPO) monotherapy should not be used as maintenance treatment due to its lack of effect on microcomedones and comedones . Topical antibiotic monotherapy is also not recommended, as long‐term therapy may lead to an increase in antibiotic‐resistant P. acnes …”

“…31 Topical antibiotic monotherapy is also not recommended, as long-term therapy may lead to an increase in antibiotic-resistant P. acnes. 32,33…”

Draft Genome Sequences of Four Propionibacterium acnes Strains Isolated from Implant-Related Infections

“…Propionibacterium acnes is a Gram-positive bacterium constituting a significant part of the human skin microbiota (1). It has been associated with skin diseases such as acne vulgaris or fulminans acne (2).…”

Modern pathogenetic therapy of acne

“…Адапален обладает противовоспалительным и комедолитическим действием, а также препятствует образованию микрокомедонов [1,15]. Метаанализ показал, что 0,1 % гель адапалена при 12-недельном при-менении приводит к улучшению у 57 % больных акне, а 0,025 % гель третиноина -у 53 %, при этом адапален переносится достоверно лучше третиноина [16].…”