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Falk Ochsendorf - One of the best experts on this subject based on the ideXlab platform.
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Systemic antibiotic therapy of acne vulgaris
Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 2010Co-Authors: Falk OchsendorfAbstract:Inflammatory, medium to severe acne vulgaris is treated with systemic antibiotics worldwide. The rationale is an effect on Propionibacterium acnes as well as the intrinsic anti-inflammatory properties of these antibiotics. Although there are no correlations between the number of P. acnes and the severity of the disease, associations between the degree of humoral and cellular immune-responses against P. acnes and the severity of acne have been reported. Exact data with respect to daily use of these compounds, such as differential effectiveness or side effects are unavailable. A summary of currently available studies is presented. The data of studies of systemic antibiotic therapy of acne vulgaris up to 1975, the summary of literature in English up to 1999, a systematic review of minocycline of the year 2002 as well as the data of randomized controlled studies published and listed in Medline thereafter were reviewed. Systemic tetracyclines [tetracycline 1 000 mg/d, doxycycline 100 (-200) mg/d, minocycline 100 (-200) mg/d, Lymecycline 300 (-600) mg] and erythromycin 1 000 mg/d are significantly more effective than placebo in the systemic treatment of inflammatory acne. The data for tetracycline are best grounded. Similarly effective is clindamycin. Cotrimoxazole and trimethoprim are likely to be effective. Definite differences between the tetracyclines or between tetracycline and erythromycin cannot be ascertained. The data for the combination with topical treatments (topical benzoyl peroxide (BPO) or retinoids) suggest synergistic effects. Therefore systemic antibiotics should not be used as monotherapy. In case of similar efficacy, other criteria, such as pharmacokinetics (doxycycline, minocycline, Lymecycline have longer half-life times than tetracyclines), the rate of side-effects (tetracycline: side effect-rate approximately 4 % mild side effects; erythromycin often gastrointestinal complaints; minocycline: rare, but potentially severe hypersensitivity reactions; doxycycline dose-dependent phototoxic reactions), the resistance-rate [percentage of resistant bacteria higher with erythromycin (approximately 50 %) than with tetracycline-therapy (approximately 20 %)], and the costs of therapy have to be taken into account. The systemic antibiotic therapy of widespread papulo-pustular acne not amenable to a topical therapy is effective and well-tolerated. In general therapy can be given for 3 months and should be combined with BPO to prevent resistance.
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Systemische Antibiotika zur Behandlung der Acne vulgaris
JDDG, 2006Co-Authors: Falk OchsendorfAbstract:Background: Inflammatory, medium to severe acne vulgaris is treated with systemic antibiotics worldwide. The rationale is an effect on Propionibacterium acnes as well as the intrinsic anti-inflammatory properties of these antibiotics. Although there are no correlations between the number of P. acnes and the severity of the disease, associations between the degree of humoral and cellular immune-responses against P. acnes and the severity of acne have been reported. Exact data with respect to daily use of these compounds, such as differential effectiveness or side effects are unavailable. A summary of currently available studies is presented. Methods: The data of studies of systemic antibiotic therapy of acne vulgaris up to 1975, the summary of literature in English up to 1999, a systematic review of minocycline of the year 2002 as well as the data of randomized controlled studies published and listed in Medline thereafter were reviewed. Results: Systemic tetracyclines [tetracycline 1 000 mg/d,doxycycline 100 (-200) mg/d, minocycline 100 (-200) mg/d, Lymecycline 300 (-600) mg] and erythromycin 1 000 mg/d are significantly more effective than placebo in the systemic treatment of inflammatory acne. The data for tetracycline are best grounded. Similarly effective is clindamycin.Cotrimoxazole and trimethoprim are likely to be effective. Definite differences between the tetracyclines or between tetracycline and erythromycin cannot be ascertained.The data for the combination with topical treatments (topical benzoyl peroxide (BPO) or retinoids) suggest synergistic effects.Therefore systemic antibiotics should not be used as monotherapy. In case of similar efficacy, other criteria, such as pharmacokinetics (doxycycline, minocycline, Lymecycline have longer half-life times than tetracyclines), the rate of side-effects (tetracycline: side effect-rate ∼4 % mild side effects; erythromycin often gastrointestinal complaints; minocycline: rare, but potentially severe hypersensitivity reactions; doxycycline dose-dependent phototoxic reactions), the resistance-rate [percentage of resistant bacteria higher with erythromycin (∼50 %) than with tetracycline-therapy '(∼20 %)],and the costs of therapy have to be taken into account. Conclusions: The systemic antibiotic therapy of widespread papulo-pustular acne not amenable to a topical therapy is effective and well-tolerated. In general therapy can be given for 3 months and should be combined with BPO to prevent resistance.
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Systemic antibiotic therapy of acne vulgaris
JDDG, 2006Co-Authors: Falk OchsendorfAbstract:BACKGROUND Inflammatory, medium to severe acne vulgaris is treated with systemic antibiotics worldwide. The rationale is an effect on Propionibacterium acnes as well as the intrinsic anti-inflammatory properties of these antibiotics. Although there are no correlations between the number of P. acnes and the severity of the disease, associations between the degree of humoral and cellular immune-responses against P. acnes and the severity of acne have been reported. Exact data with respect to daily use of these compounds, such as differential effectiveness or side effects are unavailable. A summary of currently available studies is presented. METHODS The data of studies of systemic antibiotic therapy of acne vulgaris up to 1975, the summary of literature in English up to 1999, a systematic review of minocycline of the year 2002 as well as the data of randomized controlled studies published and listed in Medline thereafter were reviewed. RESULTS Systemic tetracyclines [tetracycline 1 000 mg/d, doxycycline 100 (-200) mg/d, minocycline 100 (-200) mg/d, Lymecycline 300 (-600) mg] and erythromycin 1 000 mg/d are significantly more effective than placebo in the systemic treatment of inflammatory acne. The data for tetracycline are best grounded. Similarly effective is clindamycin. Cotrimoxazole and trimethoprim are likely to be effective. Definite differences between the tetracyclines or between tetracycline and erythromycin cannot be ascertained. The data for the combination with topical treatments (topical benzoyl peroxide (BPO) or retinoids) suggest synergistic effects. Therefore systemic antibiotics should not be used as monotherapy. In case of similar efficacy, other criteria, such as pharmacokinetics (doxycycline, minocycline, Lymecycline have longer half-life times than tetracyclines), the rate of side-effects (tetracycline: side effect-rate approximately 4 % mild side effects; erythromycin often gastrointestinal complaints; minocycline: rare, but potentially severe hypersensitivity reactions; doxycycline dose-dependent phototoxic reactions), the resistance-rate [percentage of resistant bacteria higher with erythromycin (approximately 50 %) than with tetracycline-therapy (approximately 20 %)], and the costs of therapy have to be taken into account. CONCLUSIONS The systemic antibiotic therapy of widespread papulo-pustular acne not amenable to a topical therapy is effective and well-tolerated. In general therapy can be given for 3 months and should be combined with BPO to prevent resistance.
Alasdair P Macgowan - One of the best experts on this subject based on the ideXlab platform.
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pharmacokinetics and pharmacodynamics of the tetracyclines including glycylcyclines
Journal of Antimicrobial Chemotherapy, 2006Co-Authors: Kenneth N Agwuh, Alasdair P MacgowanAbstract:The pharmacokinetics of tetracyclines and glycylcyclines are described in three groups. Group 1, the oldest group, represented by tetracycline, oxytetracycline, chlortetracycline, demeclocycline, Lymecycline, methacycline and rolitetracycline is characterized by poor absorption after food. Group 2, represented by doxycycline and minocycline, is more reliably absorbed orally, while group 3, represented by the glycylcycline tigecycline, is injectable only, with an improved antibacterial spectrum compared with the tetracyclines. Though incompletely understood, the pharmacodynamic properties of the tetracyclines and glycylcyclines are summarized.
Andrea Peserico - One of the best experts on this subject based on the ideXlab platform.
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successful treatment of melkersson rosenthal syndrome with Lymecycline
European Journal of Dermatology, 2004Co-Authors: Barbara Pigozzi, Anna Belloni Fortina, Andrea PesericoAbstract:The cause of Melkersson-Rosenthal syndrome, a granulomatous, inflammatory disease is still unknown. Many treatments have been tried with variable and often disappointing results. We report the case of a 31-year-old woman affected by Melkersson-Rosenthal syndrome, who has been successfully treated with Lymecycline, after variable results with steroids alone or combined with antihistamines, sulphasalazine and clofazimine.
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Successful treatment of Melkersson‐Rosenthal Syndrome with Lymecycline
European journal of dermatology : EJD, 2004Co-Authors: Barbara Pigozzi, Anna Belloni Fortina, Andrea PesericoAbstract:The cause of Melkersson-Rosenthal syndrome, a granulomatous, inflammatory disease is still unknown. Many treatments have been tried with variable and often disappointing results. We report the case of a 31-year-old woman affected by Melkersson-Rosenthal syndrome, who has been successfully treated with Lymecycline, after variable results with steroids alone or combined with antihistamines, sulphasalazine and clofazimine.
Teresa Gamucci - One of the best experts on this subject based on the ideXlab platform.
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Pre-emptive skin toxicity treatment for anti-EGFR drugs: evaluation of efficacy of skin moisturizers and Lymecycline. A phase II study
Supportive Care in Cancer, 2013Co-Authors: Roberta Grande, Filomena Narducci, Sara Bianchetti, Giovanni Mansueto, Donatello Gemma, Isabella Sperduti, Giorgio Trombetta, Franco Angelini, Teresa GamucciAbstract:Background Anti-epidermal growth factor receptor (EGFR) target therapies like erlotinib for metastatic lung cancer and cetuximab or panitumumab for metastatic colorectal cancer (mCRC) cause skin reaction that seems to be related to treatment efficacy. Skin toxicity evaluation protocol with panitumumab study has shown that preemptive treatment reduces the incidence of ≥Grade 2 (G2) skin toxicity in mCRC treated with panitumumab. Aim of this study is to evaluate if preemptive skin toxicity treatment with different drugs has good efficacy in patients receiving anti-EGFR therapies, such as cetuximab, panitumumab, and erlotinib, for mCRC and metastatic lung cancer. Methods Treatment included skin moisturizers with sunscreen and Lymecycline 300 mg/daily. Primary objective is to reduce the incidence of ≥G2 skin toxicity during the first 3 months of therapy. Toxicities are reported with confidence interval at 95 %. Quality of life was assessed with Dermatology Life Quality Index every 2 weeks and evaluated with repeated measure ANOVA. Results Fifty-one patients with mCRC (60.8 %) and metastatic lung cancer (39.2 %) were enrolled. Anticancer drugs were erlotinib/cetuximab/panitumumab 20:30:1. At 3-month evaluation, 27.4 % patients had =G2 skin toxicity. Skin toxicity was not related with age ( p = 0.67), sex ( p = 0.65), previous chemotherapy regimens ( p = 0.41), and current anti-EGFR treatment ( p = 0.22). No gastrointestinal or hematological toxicities related to Lymecycline were observed. Only six patients required further drugs. Quality of life analysis did not show a significant difference from the beginning and the end of treatment. Conclusions Data show efficacy of preemptive treatment with a well-tolerated profile. A reduction of severe skin toxicities is shown with an increase of grade 1 toxicities, not leading to anti-EGFR dose reduction and with better quality of life for patients.
M Alirezai - One of the best experts on this subject based on the ideXlab platform.
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Daily treatment with adapalene gel 0.1% maintains initial improvement of acne vulgaris previously treated with oral Lymecycline
European journal of dermatology : EJD, 2007Co-Authors: M Alirezai, Ian Coutts, Jean Pierre Hachem, Farzaneh Sidou, Sheru George, Diane Roseeuw, Nabil Kerrouche, Pascale SotoAbstract:Topical retinoids are often recommended for preventing acne recurrence, but there are relatively few well-controlled maintenance studies published. The objective of the present study was to assess the maintenance effect of adapalene gel 0.1% relative to gel vehicle in subjects successfully treated in a previous 12-week adapalene-Lymecycline 300 mg combination therapy study. This was a multicentre, investigator-blind, randomised, controlled study in 19 European centres. A total of 136 subjects with moderate to moderately-severe acne vulgaris who showed at least moderate improvement from baseline when treated with either adapalene plus Lymecycline or Lymecycline plus gel vehicle in a previous 12 week study were included. Subjects were randomised to receive adapalene gel 0.1% or vehicle once-daily for 12 weeks. Efficacy and safety criteria included maintenance rate, percent reduction in lesion counts (total, inflammatory, non inflammatory), global severity assessment, cutaneous tolerability, and adverse events. Adapalene provided better results relative to gel vehicle for all efficacy assessments. The maintenance rate for total lesions was 84.7% vs. 63.5% (P = 0.0049) with adapalene and the vehicle, respectively. Adapalene was safe and well tolerated in this study. This study demonstrates a clinical benefit of continued treatment with adapalene gel 0.1% as a maintenance therapy for acne.
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Systemic antibiotics for acne.
Dermatology, 1998Co-Authors: J. Meynadier, M AlirezaiAbstract:Antibiotic therapy for acne is very common. Antibiotics are frequently used in acne, either systemically or topically. Systemic antibiotics are indicated as treatment of moderate and quite severe acne or if acne is considered as very serious by the patient for psychological or social reasons. Results are very often excellent, but failure is possible; in this case using another treatment, especially isotretinoin, is necessary. A few antibiotics are useful: tetracyclines (tetracycline, doxycycline, minocycline, Lymecycline), erythromycin, co-trimoxazole and trimethoprim. Their side effects are reviewed. During pregnancy the best antibiotic is erythromycin. For the nursing mother it is generally said that tetracyclines are contraindicated but the risks if they exist are certainly slight. The mechanism of action of systemic antibiotics for acne is not perfectly clear as it is not only antimicrobial: they diminish chemotaxis of polymorphonuclear leukocytes, modify the complement pathways and inhibit the polymorphonuclear leukocyte chemotactic factor and the lipase production in Propionibacterium acnes.
