* Standard solution: 0.2 [micro]g/mL of sulfacetamide
and 4 [micro]g/mL of sulfanilamide in water.
* Topical antibiotics, most commonly clindamycin 1% or sodium sulfacetamide
, also affect both P acnes and inflammation, (24) although the exact mechanism is unknown.
A second clinical study found berberine chloride superior to sulfacetamide
in both clinical course of trachoma and achieving a drop in serum antibody titers against chlamydia (Khosla 2000).
If bacterial or viral infection is suspected, the use of the previously described topical antibiotics sulfacetamide
, gentamycin, tobramycin, erythromycin and neomycin, polymyxin B, and bacitracin should be considered (Leibowitz, 2000; Wagner, 1997a).
"We're excited about the expansion of the Prasco dermatological product line with the sodium sulfacetamide
lotion 10% product," says vice president of communications and marketing services Kimberly Carroll.
Combining the sodium sulfacetamide
and sulfur cleanser with metronidazole has yielded excellent results, Dr.
acts as a competitive antagonist to para aminobenzoic acid (PABA), a component of bacterial growth which can lead to the development of rosacea "pimples," while sulfur reportedly inhibits the growth of Propionbacterium acnes and the formation of free fatty acids.
Two other patients did not respond to therapy with topical antimicrobial agents (neomycin, propamidine isethionate, amphotericin, sulfacetamide
, and trimethoprim/sulfamethoxazole); however, several weeks after therapy was discontinued the symptoms resolved.
(9) If a patient must use drops, sulfacetamide
10%, polymyxin/trimethoprim, ciprofloxacin, or ofloxacin can be used, with the same frequency and duration.
General Approach for Treating Acne * Mild (comedonal or mixed comedonal and inflammatory lesions) --Topical benzoyl peroxide or topical retinoid OR --Topical combination therapy (benzoyl peroxide plus retinoid, benzoyl peroxide plus topical antibiotic, or benzoyl peroxide plus both topical antibiotic and retinoid) OR --Topical sulfacetamide
--Topical dapsone If response is inadequate, consider adding a retinoid product to a regimen that does not already include it, changing the concentration and/or type of vehicle in the retinoid product, or changing to a combination product that has not been tried.
Only three of the available topical therapies have demonstrated effectiveness in clinical studies and are approved for the treatment of rosacea: azelaic acid (AzA) 15 % gel; metronidazole (0.75% and 1.0%) cream, lotion, and gel; and sodium sulfacetamide
10%/sulfur 5% lotions, creams, and cleansers.