December edition of Australian Prescriber out now

Drug treatment of acne

Acne, while a common skin disorder in teenagers, can also occur in pre-adolescents and older people. Writing in the December issue of Australian Prescriber, Sydney dermatologist Dr Jo-Ann See says treatment for acne needs to be individualised, and may have to be altered as the disease changes or existing treatments become ineffective. Dr See emphasises that it is important to manage patient expectations as positive results may take several weeks. In order to minimise the risk of antibiotic resistance, a person taking oral antibiotics should not also use topical antibiotics. Oral antibiotics can be combined with topical treatments such as a retinoid or benzoyl peroxide.

Parenteral antibiotics at home

Because of increasing antibiotic resistance, many infections that were once treated with oral antibiotics have to be treated parenterally. Professor David Looke and David McDougall from Infection Management Services, Queensland write that a number of infections — such as acute cellulitis, lower respiratory tract infections and exacerbations of bronchiectasis, osteomyelitis and infective endocarditis — can now be treated safely at home. This presents unique challenges, such as selecting the right patient, drug administration intervals and stability. However, appropriate patient training and monitoring can also help.

Editorial: Quality use of medicines – are we there yet?

Much has been achieved since the introduction of a policy on the quality use of medicines in 1992. However, according to Professor Anthony Smith, Clinical Pharmacologist at the Calvary Mater Newcastle Hospital, it remains uncertain whether this has translated into better health outcomes for Australians. Professor Smith says that the quality use of medicines alone is unlikely to improve health outcomes, as factors other than medicines play a significant role. He also argues that Australia needs to tackle the quality use of complementary medicines by addressing issues of efficacy and ensuring that consumers have evidence-based information on which to base their decisions about these products.

Management of Parkinson’s disease

Also in this issue, neurologists Dr Annabelle Sellbach and Professor Peter Silburn of the University of Queensland provide advice on how to manage the motor and non-motor symptoms of Parkinson’s disease. Treatment is aimed at maintaining continuous relief of motor symptoms, which can become complex as the disease progresses. While drug treatment may be necessary in the long term, drugs alone are not sufficient to maintain quality of life. Treatment will usually require a multidisciplinary management team including general practitioners, movement disorder specialists, neuropsychiatrists and allied health professionals.

Other articles in this issue look at the management of the idiopathic interstitial pneumonias and the outcomes of the Asia Pacific Conference on National Medicines Policies. Also read about this year's top 10 drugs and safety updates for ondansetron, domperidone, fingolimod, and over-the-counter cough and cold medicines for children. New drugs for renal cell carcinoma (axitinib), postoperative nausea and vomiting (cyclizine) and Gaucher's disease (velaglucerase) are also discussed.

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Australian Prescriber is an independent peer-reviewed journal providing critical commentary on therapeutic topics for health professionals, particularly doctors in general practice. It is published every two months and distributed to health professionals free of charge, and is also available online at