Hafif ve orta şiddetli akne vulgariste topikal sodyum sulfasetamidin etkisi: açık, randomize, paralel gruplu çalışma
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Date
2008
Authors
Turan, Ayşegül
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Publisher
Uludağ Üniversitesi
Abstract
Hafif ve orta dereceli akne vulgariste en çok kullanılan topikal antibiyotikler klindamisin ve eritromisindir. Topikal antibiyotiklerin benzoil peroksit ile kombinasyonu etkinliği artırır ve Propionibacterium acnes’e karşı gelişen antibiyotik direncini azaltır. Sodyum sulfasetamid sülfonamid grubu bir antibiyotiktir. Uzun yıllardır bilindiği halde akne tedavisinde fazla kullanılmayan bu ajan son zamanlarda tekrar gündeme gelmiştir. Çalışmamızda hafif ve orta derecedeki akne vulgariste topikal sulfasetamidin etkinliğini klindamisin ve eritromisin ile karşılaştırmalı olarak değerlendirmeyi amaçladık. Randomize, açık-uçlu, paralel gruplu çalışmamızda 20 olguya sodyum sulfasetamid %10 losyon (birinci grup), 20 olguya klindamisin %1 losyon (ikinci grup) ve 20 olguya da eritromisin %2 krem (üçüncü grup) 12 hafta süre ile sabah-akşam olmak üzere günde iki kez uygulandı. Tedavi tüm hastalarda benzoil peroksit %5 losyon ile kombine edildi. Olgular başlangıçta, 4., 8. ve 12. haftalarda noninflamatuvar (açık ve kapalı komedon) ve inflamatuvar (papül ve püstül) lezyon sayıları açısından değerlendirildi ve yan etkiler kaydedildi. Gruplar arasında yaş, cinsiyet ve akne süresi yönünden anlamlı fark yoktu (p>0,05). Çalışma sonunda her 3 tedavi yöntemi ile de istatistiksel olarak anlamlı azalma saptandı (p<0,05). Noninflamatuvar lezyon sayısı ve total lezyon sayısındaki azalma açısından 4., 8. ve 12. haftalarda her 3 grup arasında anlamlı fark saptanmazken inflamatuvar lezyon sayısındaki azalma açısından 8. haftada klindamisin diğer tedavilere göre daha üstün bulundu (p<0,05). Yan etki görülme oranları açısından da her 3 grup arasında anlamlı fark saptanmadı (p>0,05). Bu çalışmada topikal sodyum sulfasetamidin, hafif ve orta şiddette akne vulgarisin tedavisinde, benzoil peroksitle kombine kullanıldığında klindamisin ve eritromisin gibi etkili ve güvenilir olduğu sonucuna varılmıştır. Bu sonuç daha geniş olgu sayılı çalışmalarla desteklenmelidir.
Clindamycin and erythromycin are the most widely used topical antibiotics in mild and moderate acne vulgaris. Combination of topical antibiotics with benzoyl peroxide increases efficacy and reduces antibiotic resistance to Propionibacterium acnes. Sodium sulfacetamide is a sulfonamide antibiotic. This agent, which is not widely used in acne treatment although it has been known for many years, acquired currency recently again. In this study, we aimed to assess the efficacy of the sodium sulfacetamide comparing with the other widely used topical antibiotics in mild and moderate acne vulgaris. In our randomized, open-labeled, parallel grouped study, 20 cases were given sodium sulfacetamide 10% lotion (1st group), 20 cases were given clindamycin 1% solution (2nd group), and 20 cases were given erythromycin 2% gel (3rd group) twice daily for 12 weeks. Treatment was combined with benzoyl peroxide in all groups. Noninflammatory (open and closed comedones) and inflammatory (papules and pustules) lesion counts were assessed at 4., 8. and 12. weeks and adverse events were recorded. There was no significant difference between groups for age, sex and acne duration (p>0.05). Statistically significant decrease was obtained with all 3 treatments at the end of the study (p<0.05). No significant difference was detected between 3 groups for noninflammatory and total lesion counts at 4. 8. and 12. weeks, but clindamycin was superior to other treatments at 8th week (p<0.05). There was no statistically difference for adverse effect rates between groups (p>0.05). In this study, topical sodium sulfacetamide was found to be as effective and safe as erythromycin and clindamycin when combined with benzoyl peroxide in the treatment of mild and moderate acne vulgaris. These results should be supported by further and larger studies.
Clindamycin and erythromycin are the most widely used topical antibiotics in mild and moderate acne vulgaris. Combination of topical antibiotics with benzoyl peroxide increases efficacy and reduces antibiotic resistance to Propionibacterium acnes. Sodium sulfacetamide is a sulfonamide antibiotic. This agent, which is not widely used in acne treatment although it has been known for many years, acquired currency recently again. In this study, we aimed to assess the efficacy of the sodium sulfacetamide comparing with the other widely used topical antibiotics in mild and moderate acne vulgaris. In our randomized, open-labeled, parallel grouped study, 20 cases were given sodium sulfacetamide 10% lotion (1st group), 20 cases were given clindamycin 1% solution (2nd group), and 20 cases were given erythromycin 2% gel (3rd group) twice daily for 12 weeks. Treatment was combined with benzoyl peroxide in all groups. Noninflammatory (open and closed comedones) and inflammatory (papules and pustules) lesion counts were assessed at 4., 8. and 12. weeks and adverse events were recorded. There was no significant difference between groups for age, sex and acne duration (p>0.05). Statistically significant decrease was obtained with all 3 treatments at the end of the study (p<0.05). No significant difference was detected between 3 groups for noninflammatory and total lesion counts at 4. 8. and 12. weeks, but clindamycin was superior to other treatments at 8th week (p<0.05). There was no statistically difference for adverse effect rates between groups (p>0.05). In this study, topical sodium sulfacetamide was found to be as effective and safe as erythromycin and clindamycin when combined with benzoyl peroxide in the treatment of mild and moderate acne vulgaris. These results should be supported by further and larger studies.
Description
Keywords
Akne, Benzoil peroksit, Eritromisin, Klindamisin, Sodyum sulfasetamid, Acne, Benzoyl peroxide, Clindamycin, Erythromycin, Sodium sulfacetamide
Citation
Turan, A. (2008). Hafif ve orta şiddetli akne vulgariste topikal sodyum sulfasetamidin etkisi: açık, randomize, paralel gruplu çalışma. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.