Comparison of the Efficacy of Topical Clindamycin versus Niacinamide in the Treatment of Mild to Moderate Acne Vulgaris: a Systematic Review

Eden Leonita, T. Setyaningrum, Mohammad Fathul Qorib, D. .
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Abstract

Background: Acne vulgaris (AV) is one of the most common skin diseases among teenagers and is treated based on its severity. Mild acne is treated with topical agents, while moderate and severe acne are treated with a combination of topical and systemic agents. Topical agents that are often used for acne are antibiotics, such as topical clindamycin. Widespread use of antibiotics to treat AV causes resistance problems. Therefore, alternative therapies are needed to prevent resistance to topical clindamycin, such as topical niacinamide, which has anti-inflammatory effects without inducing resistance problems. Purpose: To compare the efficacy of topical clindamycin and topical niacinamide in mild to moderate AV. Methods: In this systematic review, a literature search was carried out through 6 databases, following PRISMA 2020 guidelines. Inclusion criteria were written in English or Indonesian, published in 2010-2020, randomized controlled trial (RCT) study design, conducted on human samples, and discussed the efficacy comparison of topical clindamycin and niacinamide in mild to moderate AV. Studies that were not accessible in full-text and based on secondary data were excluded. Quality and risk of bias assessments were done using The Jadad Scale and Risk of Bias 2 (RoB 2). Result: Acne severity was reduced significantly in both topical clindamycin and niacinamide groups, and there was no efficacy difference between these groups. Both topical clindamycin and topical niacinamide can cause mild side effects. Conclusion: Topical niacinamide can be an alternative therapy to topical clindamycin because they are both effective in treating mild to moderate AV.
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外用克林霉素与烟酰胺治疗轻至中度寻常性痤疮疗效的比较:系统综述
背景:寻常痤疮(AV)是青少年中最常见的皮肤病之一,其治疗主要基于其严重程度。轻度痤疮用局部药物治疗,而中度和重度痤疮用局部和全身药物联合治疗。通常用于治疗痤疮的外用药物是抗生素,如外用克林霉素。广泛使用抗生素治疗AV会导致耐药性问题。因此,需要替代疗法来防止对外用克林霉素的耐药,例如外用烟酰胺,它具有抗炎作用而不会引起耐药问题。目的:比较外用克林霉素和外用烟酰胺治疗轻中度AV的疗效。方法:在本系统综述中,按照PRISMA 2020指南,通过6个数据库进行文献检索。纳入标准以英文或印尼语撰写,发表于2010-2020年,采用随机对照试验(RCT)研究设计,在人体样本中进行,并讨论了外用克林霉素和烟酰胺治疗轻至中度AV的疗效比较。排除了无法获得全文和基于二手数据的研究。采用Jadad量表和2级偏倚风险(RoB 2)进行偏倚质量和风险评估。结果:外用克林霉素组和烟酰胺组均显著降低了痤疮严重程度,两组间疗效无差异。外用克林霉素和外用烟酰胺都能引起轻微的副作用。结论:外用烟酰胺可作为克林霉素外用的替代疗法,二者均可有效治疗轻中度AV。
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