Pharmacotherapy for Acne Vulgaris: Oral Antibacterials

Erythromycin is available alone and in combination with ______ or benzoyl peroxide

Oral clindamycin can cause pseudomembranous ______

Combination of Erythromycin and ______ is applied twice daily

Benzoyl peroxide is metabolized to ______ acid

Systemic antibiotics are standard therapy for moderate and severe acne and treatment-resistant inflammatory acne. Because of increasing bacterial resistance, patients with less severe forms should not be treated with oral antibiotics, and where possible duration of therapy should be limited (eg, 6-8 weeks) Erythromycin is effective, but because of bacterial resistance, its use should be limited to patients who cannot use a ______ derivative (eg, pregnant women and children

Topical retinoids, especially ______, are drugs of choice for acne vulgaris.

Either the fixed-dose combination of adapalene and ______ or the fixed-dose combination of topical clindamycin and ______ is first choice therapy for acne vulgaris.

As alternatives, a different topical retinoid used with a different topical antimicrobial agent could be used, with or without ______.

In cases of widespread disease, a combination of a systemic antibiotic with either ______ or adapalene in fixed combination with benzoyl peroxide can be considered.

If there are limitations in the use of first-choice agents, alternatives include fixed-dose combination of erythromycin and ______.

The fixed-dose combination of isotretinoin and ______ is an alternative in cases of limitations in the use of first-choice agents.

Tazarotene (Tazorac) is as effective as adapalene in reducing non-inflammatory and inflammatory lesion counts when applied half as frequently, and more effective for inflammatory lesions when applied once daily.

Benzoyl peroxide is bactericidal and also suppresses sebum production and reduces free fatty acids, which are comedogenic and inflammatory triggers. It is an agent of first choice when combined with ______ for most patients with mild to moderate inflammatory acne vulgaris.

Topical erythromycin and clindamycin have become less effective due to resistance by P.acnes. Addition of benzoyl peroxide or topical retinoids to the macrolide is more effective than antibiotic monotherapy. Clindamycin is preferred because of potent action and lack of systemic absorption. It is available as a single ingredient topical preparation or in combination with ______.

Benzoyl peroxide can be added to a topical retinoid for maintenance therapy. Side effects of benzoyl peroxide include dryness, irritation, and rarely, allergic contact dermatitis. It may bleach hair and ______.

Tretinoin is a synthetic acetylenic retinoid, is a prodrug which is converted to tazarotenic acid. The product is available as a 0.05% and 0.1% gel or ______.

Benzoyl peroxide is often combined with topical retinoids or an antimicrobial. For maintenance therapy, benzoyl peroxide can be added to a topical ______.