# _Cutibacterium acnes_ Dysbiosis: Alternative Therapeutics for Clinical Application
## 2 New Therapeutic Strategies
\begin{table}
\begin{tabular}{c c c c} \hline \hline
**Compound** & **Antibacterial Mechanism** & **Positive Factors** & **Negative Factors** \\ \hline \multirow{4}{*}{Clindamycin} & \multirow{4}{*}{Inhibits the bacterial 50S ribosome-mediated protein production.} & Has a synergetic effect when used with BPO. Fox-Fordyce illness, folliculitis, perioritical face dermatitis, and rosacea have all been treated successfully with topical clindamycin, according to reports. & \(\mathbb{C}\)_actes_ isolates was shown to be resistant to clindamycin. Topical clindamycin side effects generally take the shape of dryness, topical clindamycin, according to reports. & \(\mathbb{C}\)_actes_ is was shown to be resistant to clindamycin. Topical clindamycin side effects generally take the shape of dryness, stinging, burning, and erythema. \\ \hline \multirow{4}{*}{Micozanole Nitrate (MN)} & Antifungal drug that affects the integrity of fungal cell membranes. & Annihilates Malassezia furfur, a fungus that provides an optimal environment for the growth of C. acnes. & May provoke allergic reactions, skin irritation such as erythema, pruritus, and occasionally exudation. \\ \hline \multirow{4}{*}{Hydrogen Peroxide (HP)} & Is known by its powerful antiseptic activity against the vast known microorganisms in the skin. It can be used in the resistance to HP have been reported. PVP-I and HP interact positively. & HP concentrated solutions (20-30\% or more) are extremely irritating to the skin and mucous membranes and should be handled carefully. \\ \cline{1-1}  & & Being a highly safe topical medication, chlorohexidine is also commonly found in wound dressings and central line catheters. Chlorohexidine has a broad spectrum of activity and persistent residual effects. & Associated with poor efficacy, chlorohexidine side effects are uncommon but include minor skin irritation and, less often, allergic responses such as severe anaphylaxis. \\ \hline \multirow{4}{*}{Povidone-iodine (PVP-I)} & It is hypothesized that PVP-I mechanisms include the inhibition of the electron transportation and cellular and inhibiting protein synthesis. & It is considered, among the antiseptics, the one with the broadest spectrum of activity against viruses, bacteria, molds, fungi, yeasts, and protozoa. & Low solubility, poor chemical stability, and shows local toxicity if not used in a soluble polymer matrix. PVP-I should not be used in patients with thyroid diseases and applicated iodine radiotherapy and it is also contraindicated to pregnant women or during lactation, and to venpowers, and to young children. \\ \hline \multirow{4}{*}{Isopropanol} & It is hypothesized that alcohols promote the protein denaturation or inhibition of mRNA and protein synthesis. & Rapid bacterial activity and broad spectrum of activity (vegetative bacteria, including mycobacteria, viruses, fungi, but not against bacterial spores). No reported allergic reactions. & Alcohols’ antimicrobial properties are brief, so they are commonly combined with compounds such as chlorohexidine, which keep working after the alcohol has evaporated. \\ \hline \hline \end{tabular}
\end{table} 
Table 4: _Cont._of _C. acnes_, as well as an in vivo assay on the skin of patients with oily skin and severe AV. The postbiotics displayed a good growth inhibition for _C. acnes_, and in clinical trials no adverse effects was observed, showing significant reduction in redness, inflammation, and accumulation of porphyrins in skin brown spots. Moreover, there was a significant improvement in the skin hydration and in the AV lesions (in only one week of treatment), even though there was no significant reduction in the sebum skin [30]. [PERSON] et al. studied the effects of the _E. faecalis_ CBT SL-5 extract, isolated from healthy Korean human fecal samples in patients with mild to moderate AV. The treatment significantly reduced the phylogenetic diversity in the patient's skin and was well tolerated by the patients.