A study of prescription pattern in the drug therapy of acne vulgaris at a tertiary care hospital in Mangalore, India

Background: Acne Vulgaris is the most common skin disorder of the pilosebaceous unit with excess sebum production, follicular epidermal hyperproliferation, inflammation and Propionibacterium acnes activity, affecting about 80% of teenagers and has considerable psychological and social consequences and physical disability. Use of established topical and oral drugs assumes paramount importance in the treatment of acne vulgaris. Therefore, periodic auditing of prescription is necessary to increase therapeutic benefit and decrease adverse effects. Aim and objectives of the study was to evaluate the pattern of prescription and its rationale in the drug therapy of acne vulgaris. To monitor the adverse effects, if any.Methods: A prospective, hospital based, observational study. Data was collected for a period of 1 year from January 2015 to December 2015 from the outpatient records in the OPD of Dermatology at Justice K.S. Hegde Charitable Hospital, Deralakatte, Mangalore, in a specifically designed proforma.Results: The prescription data of 346 patients were analyzed of which 45.1% were males with an average age of 21.94±0.3 years. Among the four grades of Acne Vulgaris, Grade II (53.17%) was more prevalent followed by Grade I (26.58%), Grade III (13.87%) and Grade IV (6.35%). The number of drugs prescribed for topical use was 514 of which the most commonly prescribed drugs were Benzoyl Peroxide (19.46%), a combination of Tretinoin and Clindamycin (17.12%), Tretinoin alone (12.45%), Clindamycin alone (10.51%) etc. The number of drugs prescribed for systemic use was 98 consisting of Doxycycline (55.1%), Azithromycin (34.7%), Isotretinoin (6.12%) and Erythromycin (4.08%).Conclusions: There was rationality in most of the prescriptions giving no scope for polypharmacy

4-[(4-Chloro­phen­yl)(5-hydr­oxy-3-methyl-1-phenyl-1H-pyrazol-4-yl)meth­yl]-5-methyl-2-phenyl-1H-pyrazol-3(2H)-one

In the the title compound, C27H23ClN4O2, the chloro­phenyl ring forms dihedral angles of 77.70 (9) and 86.65 (9)°, respectively, with the pyrazol-3-one and pyrazole rings. The phenyl rings attached to the pyrazole rings are twisted away from them [dihedral angles 33.80 (9) and 40.34 (10)°]. An intramolecular O—H⋯O hydrogen bond generates an S(8) ring motif. The mol­ecules are linked into chains running along the c axis by N—H⋯N hydrogen bonds, and the chains are cross-linked via C—H⋯O hydrogen bonds and C—H⋯π inter­actions involving the chloro­phenyl ring

4-[(5-Hydr­oxy-3-methyl-1-phenyl-1H-pyrazol-4-yl)phenyl­meth­yl]-5-methyl-2-phenyl-1H-pyrazol-3(2H)-one ethanol hemisolvate

The asymmetric unit of the title compound, C27H24N4O2·0.5C2H6O, comprises two crystallographically independent mol­ecules (A and B) with slightly different conformations, and one ethanol mol­ecule of crystallization. Intra­molecular C—H⋯O and O—H⋯O hydrogen bonds generate six- and eight-membered rings, producing S(6) and S(8) ring motifs, respectively. In mol­ecule A, one of the benzene rings is disordered over two positions, with site-occupancy factors of 0.542 (11) and 0.458 (11). The dihedral angles between the central benzene ring and the two outer benzene rings are 73.88 (9) and 82.6 (2)/88.9 (2)° in mol­ecule A, and 80.81 (8) and 79.38 (8)° in mol­ecule B. In the crystal structure, mol­ecules form infinite one-dimensional chains in the (101) plane. The crystal structure is stabilized by inter­molecular O—H⋯N, N—H⋯N, N—H⋯O and C—H⋯O hydrogen bonds, weak C—H⋯π and π–π [centroid–centroid = 3.5496 (1) Å] inter­actions

4-Amino-3-{1-[4-(2-methyl­prop­yl)phen­yl]eth­yl}-1H-1,2,4-triazole-5(4H)-thione

In the title triazole compound, C14H20N4S, the dihedral angle between the triazole and benzene rings is 83.29 (11)°. The methine H atom and two methyl groups of the isobutyl group are disordered over two sites with occupancies of 0.684 (9) and 0.316 (9). In the crystal structure, N—H⋯S hydrogen bonds link the mol­ecules into chains running along the b axis. These chains are cross-linked into a two-dimensional network parallel to the ab plane by C—H⋯S hydrogen bonds

4-[(E)-2,6-Dichloro­benzyl­ideneamino]-3-{1-[4-(2-methyl­prop­yl)phen­yl]eth­yl}-1H-1,2,4-triazole-5(4H)-thione

In the title Schiff base compound, C21H22Cl2N4S, the triazole ring makes dihedral angles of 2.15 (11) and 87.48 (11)° with the 2,6-dichloro­phenyl and methyl­propyl­phenyl rings, respectively. Weak intra­molecular C—H⋯S and C—H⋯Cl inter­actions generate S(6) and S(5) ring motifs, respectively. In the crystal structure, centrosymmetrically related mol­ecules are linked into dimers by N—H⋯S hydrogen bonds. These dimers are arranged into sheets parallel to the ab plane and are stacked along the c axis. C—H⋯π inter­actions involving the methyl­propyl­phenyl ring and π–π inter­actions involving the dichloro­phenyl ring [centroid–centroid distance = 3.5865 (3) Å] are also observed

4-(4-Bromo­benzyl­ideneamino)-3-{1-[4-(2-methyl­prop­yl)phen­yl]eth­yl}-1-(mor­phol­ino­meth­yl)-1H-1,2,4-triazole-5(4H)-thione

There are two mol­ecules (A and B) in the asymmetric unit of the title compound, C26H32BrN5OS, with almost identical geometry. The morpholine ring adopts the usual chair conformation in both mol­ecules. The triazole ring forms dihedral angles of 4.84 (6) and 74.19 (6)°, respectively, with the bromo­phenyl and isobutylbenzene rings in mol­ecule A, and angles of 16.68 (7) and 87.29 (6)°, respectively, in mol­ecule B. Intra­molecular C—H⋯S hydrogen bonds generate S(5) and S(6) ring motifs in both independent mol­ecules. The crystal structure is stabilized by C—H⋯N, C—H⋯Br and C—H⋯O hydrogen-bonding inter­actions, together with C—H⋯π inter­actions

3-[1-(4-Isobutyl­phen­yl)eth­yl]-6-(4-methyl­phen­yl)-1,2,4-triazolo[3,4-b][1,3,4]thia­diazole

In the title compound, C22H24N4S, the methylphenyl and isobutylphenyl rings are inclined at an angle of 79.98 (1)° and they form dihedral angles of 4.59 (1) and 75.47 (1)°, respectively, with the triazolothia­diazole unit. An intra­molecular C—H⋯S hydrogen bond generates an S(5) ring motif. The crystal structure is stabilized by inter­molecular C—H⋯N hydrogen bonds and weak C—H⋯π and π–π inter­actions [centroid–centroid distances between the thia­diazole ring and a symmetry-related phenyl ring and between the triazole ring and the phenyl ring range from 3.5680 (8) to 3.7313 (8) Å]