Subject(s)
Ethnicity/genetics , Pharmacogenetics , Terminology as Topic , Area Under Curve , Asia , Ethnicity/classification , Fluorobenzenes/pharmacokinetics , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/pharmacokinetics , Pyrimidines/pharmacokinetics , Rosuvastatin Calcium , Sulfonamides/pharmacokineticsABSTRACT
BACKGROUND: We investigated the efficacy and cost-effectiveness of five antimicrobial regimens for mild to moderate facial acne and whether propionibacterial antibiotic resistance affects treatment response. METHODS: In this randomised, observer-masked trial, 649 community participants were allocated one of five antibacterial regimens. Primary outcomes were patients' self-assessed improvement and reduction in inflamed lesions at 18 weeks. Analyses were by intention to treat. FINDINGS: Moderate or greater improvement at 18 weeks was reported in 72 (55%) of 131 participants assigned oral oxytetracycline plus topical placebo, 70 (54%) of 130 assigned oral minocycline plus topical placebo, 78 (60%) of 130 assigned topical benzoyl peroxide plus oral placebo, 84 (66%) of 127 assigned topical erythromycin and benzoyl peroxide in a combined formulation plus oral placebo, and 82 (63%) of 131 assigned topical erythromycin and benzoyl peroxide separately plus oral placebo. Most improvement occurred in the first 6 weeks. Treatment differences for the proportion of people with at least moderate improvement were: minocycline versus oxytetracycline -1.2% (unadjusted 95% CI -13.3 to 10.9); combined erythromycin and benzoyl peroxide versus oxytetracycline 11.1% (-0.7 to 22.9) and versus minocycline 12.3% (0.4 to 24.2); erythromycin and benzoyl peroxide separately versus combined formulation -3.5% (-15.2 to 8.2); benzoyl peroxide versus oxytetracycline 5.0% (-7.0 to 17.0), versus minocycline 6.2% (-5.8 to 18.2), and versus combined formulation -6.1% (-17.9 to 5.7). Benzoyl peroxide was the most cost-effective treatment. Efficacy of both tetracyclines was reduced by pre-existing tetracycline resistance. INTERPRETATION: Topical benzoyl peroxide and benzoyl peroxide/erythromycin combinations are similar in efficacy to oral oxytetracycline and minocycline and are not affected by propionibacterial antibiotic resistance.
Subject(s)
Acne Vulgaris/drug therapy , Anti-Bacterial Agents/administration & dosage , Facial Dermatoses/drug therapy , Acne Vulgaris/economics , Acne Vulgaris/microbiology , Administration, Oral , Administration, Topical , Adolescent , Adult , Anti-Bacterial Agents/adverse effects , Anti-Bacterial Agents/economics , Benzoyl Peroxide/administration & dosage , Child , Cost-Benefit Analysis , Erythromycin/administration & dosage , Erythromycin/adverse effects , Erythromycin/economics , Facial Dermatoses/microbiology , Female , Humans , Male , Minocycline/administration & dosage , Minocycline/adverse effects , Minocycline/economics , Oxytetracycline/administration & dosage , Oxytetracycline/adverse effects , Oxytetracycline/economics , Single-Blind Method , Skin/microbiologyABSTRACT
A method has been proposed for extracting numerical data when only graphical results are presented. Reports with both graphical and tabular data were identified and the graphs were electronically scanned. The coordinates of each point were read using the cross-hair facility of Adobe Photoshop 7.0. To improve the precision of these coordinates, each point was read at 1600% magnification. The agreement between the observers was almost perfect (R > 0.99). The proposed method makes possible use of data in meta-analyses that, would otherwise be discarded.