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This site complies with the HONcode standard for trustworthy health information: verify here. This content does not have an English version. This content does not have an Arabic version. See more conditions. Drugs and Supplements Clindamycin Topical Route.
Products and services. Proper Use Drug information provided by: IBM Micromedex Before applying this medicine, thoroughly wash the affected areas with warm water and soap, rinse well, and pat dry. Thank you for Subscribing Our Housecall e-newsletter will keep you up-to-date on the latest health information. Please try again. In fact, within a primary care setting, the only alternative is the oral contraceptive pill; but the NICE draft guidelines suggest that clinicians only consider recommending this for people who are already seeking a hormonal contraceptive, in preference to the progesterone-only pill, which is thought to potentially exacerbate acne.
In terms of the antibiotics themselves, the draft guidance warns about antimicrobial resistance, and advises clinicians to always prescribe topical and oral antibiotics in conjunction with a non-antibiotic topical when treating acne, but never together. These strategies are thought to help limit resistance and, although the guideline allows for patients to be on antibiotics for up to six months, it advises regular, weekly reviews.
If it does work, when patients come off oral antibiotics, they sometimes suffer a rebound of their acne. The draft NICE guideline says to consider a fixed combination of topical adapalene and benzoyl peroxide as maintenance treatment for acne. If this is not tolerated, it advises topical monotherapy with a non-antibiotic topical agent. Even when patients reach secondary care, there is not a huge amount of choice. Isotretinoin can be effective, but it requires regular monitoring and has been associated with sexual and mental health effects, which triggered an ongoing review by the Medicines and Healthcare products Regulatory Agency.
Other than that, the only other oral treatment in fairly widespread use, at least in the United States, is the, as yet unlicensed, diuretic spironolactone, which seems to work in acne through an effect on androgen receptors. Given the lack of alternatives, the key to reducing antibiotic use in acne may lie in making sure that the patients who receive oral antibiotics really need them.
Rafiq, who was on the committee that prepared the NICE guidelines but does not speak for them, agrees that pharmacists have an important role in counselling patients on how to use these treatments correctly. This, says Santer, is vital. Instead, she suggests counselling patients to start off slowly and build up their use.
It is no wonder that patients are keen to see the effect of treatment. But if patients present to their GP too soon, before giving topical treatments a proper chance, they may end up on antibiotics unnecessarily.
What is more, Santer says, oral treatments are sometimes perceived to be more effective than they are, by both doctors and patients. Access provided by. Clindamycin is available as a lotion, gel, foam or solution. Follow the instructions provided with your medication and apply it to areas of your skin that are affected by acne. Before applying clindamycin, make sure that your skin is clean. Make sure to wash the affected area with warm water and gently dry it before applying your medication.
Only apply as much as your healthcare provider recommends. Clindamycin is only safe for use on your skin. Make sure to avoid getting the medication close to or in your eyes, nose, mouth or areas with broken skin. If you accidentally apply clindamycin to these areas, make sure to rinse them thoroughly using cool water. Do not smoke while applying clindamycin, as some clindamycin products may be flammable. Benzoyl peroxide is an over-the-counter acne treatment that works by reducing bacteria on the surface of the skin.
Some topical acne treatments combine clindamycin with benzoyl peroxide for an extra effect against acne. Tretinoin is a topical retinoid. Tretinoin and clindamycin are often used together to treat acne. In one study from , researchers found that a combination of tretinoin and clindamycin was more effective at getting rid of acne than topical clindamycin by itself.
Oral antibiotics are best used with concomitant BP or topical retinoids. The oral antibiotics most commonly used when treating acne include doxycycline and minocycline. Each of these tetracycline-class antibiotics possess unique adverse effect profiles.
Doxycycline use may result in gastrointestinal upset so-called pill esophagitis or a hypersensitivity syndrome. Patients are best counseled to take doxycycline with at least 8 ounces of fluid and to remain upright for 60 minutes following administration ie, do not take at bedtime. Fluid choices may include milk because doxycycline is less susceptible to reduced oral absorption when taken with milk as compared with tetracycline.
Additionally, minocycline may result in vertigo or dizziness. More serious adverse effects from minocycline include hypersensitivity reactions, lupus-like syndrome and hepatitis. Patient counseling and monitoring for these potential adverse effects are of paramount importance when doxycycline and minocycline are used.
Doxycycline is available as numerous specific brand and generic products. Less expensive doxycycline products include generic hyclate and monohydrate salt forms, as capsule or tablet products. Both doxycycline and minocycline are commonly dosed as 50 to mg once or twice daily.
Despite the publication of several dose-ranging studies, the most effective doxycycline or minocycline dose has not been determined. An additional consideration when using oral antibiotic therapy is treatment duration. Several recently published studies have demonstrated that oral antibiotics may be commonly given for treatment durations significantly longer than recommended. When individuals respond to oral antibiotic therapy, clinical efficacy is often noticed within 4 to 8 weeks of treatment initiation.
Guideline recommendations include use of to week treatment durations, or less ie, discontinue 4 to 8 weeks after new lesion formation. Treatment durations of up to 24 weeks may be appropriate if clinical improvement is continuing.
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