Retinoid plus antibiotic is the standard Tx for acne: international expert panel.(Clinical Rounds)

BARCELONA, SPAIN -- Combination therapy utilizing a topical retinoid and an antibiotic ought now to be considered the standard of care in treating mild to moderate acne, according to practice guidelines created by an international blue ribbon panel of acne experts.

"This should be the treatment of choice for the vast majority of patients. It's sufficient to control perhaps 85% of cases of acne," Dr. James J. Leyden asserted at a satellite symposium devoted to a presentation of the guidelines in conjunction with the 12th Congress of the European Academy of Dermatology and Venereology.

Dr. Leyden, professor of dermatology at the University of Pennsylvania, Philadelphia, is a member of the guidelines panel, known as the Global Alliance to Improve Outcomes in Acne.

Dr. Harald Gollnick, chairman of the alliance, described the guidelines as primarily evidence based, with reliance upon expert consensus to fill in the gaps, including, for example, the importance of long-term maintenance therapy once acne clearing has been achieved.

The need for new guidelines on acne therapy arises because formerly there were no internationally accepted guidelines. Moreover, many physicians today rely on outdated prescribing habits. Liberal long-term prescribing of antibiotics for the treatment of acne has emerged as a major contributor to the growing problem of bacterial antibiotic resistance, said Dr. Gollnick, chairman of the department of dermatology and venereology at Otto-von-Guericke University in Magdeburg, Germany.

In addition, the last several years have brought important new insights into the multiple pathophysiologic mechanisms involved in acne, as well as new drugs to treat the disorder, he added at the ...