Retinoid-like Agents
Class Summary
These agents modulate keratinocyte differentiation and decrease sebum production.
Isotretinoin (Claravis, Amnesteem, Sotret, Myorisan)
An oral agent that treats serious dermatologic conditions, isotretinoin is synthetic 13-cis isomer of naturally occurring tretinoin (trans-retinoic acid). Both agents are structurally related to beta-carotene. Isotretinoin decreases sebaceous gland size and sebum production. It may inhibit sebaceous gland differentiation and abnormal keratinization.
A US Food and Drug Administration–mandated registry is now in place for all individuals prescribing, dispensing, or taking isotretinoin. For more information on this registry, see iPLEDGE. This registry aims to further decrease the risk of pregnancy and other unwanted and potentially dangerous adverse effects during a course of isotretinoin therapy.
Female patients must sign an informed consent that they will use contraceptives during treatment course and for 30 days after discontinuing therapy.
Antibiotics, Other
Class Summary
Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting. Antibiotic selection should be guided by blood culture sensitivity whenever feasible.
Ampicillin (Principen, Omnipen, Marcillin)
Ampicillin has bactericidal activity against susceptible organisms. It is an alternative to amoxicillin if the patient is unable to take medication orally.
Trimethoprim and sulfamethoxazole (Bactrim, Septra)
Trimethoprim and sulfamethoxazole combination inhibits bacterial growth by inhibiting the synthesis of dihydrofolic acid.
Ticarcillin and clavulanate potassium (Timentin)
This drug combination inhibits the biosynthesis of cell wall mucopeptide and is effective during the stage of active growth. It consists of an antipseudomonal penicillin plus a beta-lactamase inhibitor and provides coverage against most gram positives, most gram negatives, and most anaerobes.
Acne Agents, Topical
Class Summary
Acne products are used for the treatment of mild to moderate acnes vulgaris. These agents may have antibacterial and comedolytic properties. In severe cases the agents may be used as an adjunct in therapeutic regimens.
Benzoyl peroxide (BenzEFoam, PanOxyl, Neutrogena On The Spot, Invisible Acne Treatment)
Benzoyl peroxide is an oxidizing agent that possesses antibacterial properties and is comedolytic. The antibacterial activity results from the release of active or free-radical oxygen that can oxidize bacterial proteins. Benzoyl peroxide is oxidized into benzoic acid with contact to the skin. It is available over the counter and by prescription. It may be used to treat residual acne once the folliculitis has responded,
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Pseudomonas folliculitis. Courtesy of Hon Pak, MD.
