Oral antibiotics in acne vulgaris: therapeutic response over 5 year

  • Adawiyah J
  • Priya G
  • Roshidah B
Keywords: Antibiotics, acne vulgaris

Abstract

Introduction: Antibiotic resistant P. acnes have influenced acne therapy worldwide resulting in increased use of topical and systemic retinoids. Judicious use of oral antibiotic is important for effective therapeutic outcome.

Objectives: To determine the response and side effects of oral antibiotic treatment in acne vulgaris. To determine the type of antibiotic used, therapy duration and the types of concomitant topical therapy.

Methods: Retrospective analysis of the therapeutic response to oral antibiotics therapy in acne vulgaris in the Dermatology Department, Hospital Kuala Lumpur. New cases of acne vulgaris from 2005 to 2009 were randomly selected. The clinical notes of 250 patients treated with oral antibiotics were reviewed.

Results: About 60% of patients achieved good to excellent response to therapy while satisfactory response was seen in 26%. Only 8% patients experienced minor side effects. Doxycycline was the most frequently prescribed antibiotic, followed by tetracycline and erythromycin ethylsuccinate. The prescribing pattern was consistent over the years. The mean duration of treatment is four to five months. Oral antibiotic was augmented with topical therapy in 98.8% of patients.

Conclusion: Good to excellent therapeutic response was achieved in the majority of patients and results observed have remained stable over the last five years.

References

White GM. Recent findings in the epidemiologic evidence, classification, and subtypes of acne vulgaris. J Am Acad Dermatol. 1998;39(2 Pt 3):S34-7.

Yeung CK, Teo LHY, Xiang LH, et al. A community-based epidemiological study of acne vulgaris in Hong Kong adolescents. Acta Derm Venereol. 2002;82(2):104–7.

Hanisah A, Omar K, Shah SA. Prevalence of acne and its impact on the quality of life in school-aged adolescents in Malaysia. J Prim Health Care. 2009;1(1):20-5.

Harper JC. An update on the pathogenesis and management of acne vulgaris. J Am Acad Dermatol. 2004;51(1 Suppl): S36-8.

Leyden JJ. The evolving role of Propionibacterium acnes in acne. Semin Cutan Med Surg. 2001;20(3):139-43.

Strauss JS, Krowchuck DP, Leyden JJ, et al. Guidelines of care for acne vulgaris management. J Am Acad Dermatol. 2007;56(4):651-63.]

Ross JI, Snelling AM, Carnegie E, et al. Antibiotic-resistant acne: lessons from Europe. Br J Dermatol. 2003;148(3):467-78.

Coates P, Vyakrnam S, Eady EA, et al. Prevalence of antibioticresistant propionibacteria on the skin of acne patients: 10-year surveillance data and snapshot distribution study. Br J Dermatol. 2002;146(5):840–8.

Thevarajah S, Balkrishnan R, Camacho FT, et al. Trends in prescription of acne medication in the US: shift from antibiotic to non-antibiotic treatment. J Dermatolog Treat. 2005;16(4):224-8.

Eady AE, Cove JH, Layton AM. Is antibiotic resistance in cutaneous propionibacteria clinically relevant? : implications of resistance for acne patients and prescribers. Am J Clin Dermatol. 2003;4(12):813-31.

Thiboutot D, Gollnick H, Bettoli V, et al. New insights into the management of acne: an update from the Global Alliance to improve outcomes in acne group. J Am Acad Dermatol. 2009;60(5 Suppl):S1-50.

Pochi PE, Shalita AR, Strauss JS, et al. Report of the Consensus Conference on Acne Classification. Washington, D.C., March 24 and 25, 1990. J Am Acad Dermatol. 1991;24(3):495-500.

Leyden JJ, Kaidbey K, Gans EH. The antimicrobial effects in vivo of minocycline, doxycycline and tetracycline in humans. J Dermatolog Treat. 1996;7(4):223-25.

Leyden JJ, Del Rosso JQ, Webster GF. Clinical considerations in the treatment of acne vulgaris and other inflammatory skin disorders: a status report. Dermatol Clin. 2009;27(1):1-15.

Espersen F. Resistance to antibiotics used in dermatological practice. Br J Dermatol. 1998;139 Suppl 53:4-8.

Ozolins M, Eady EA, Avery AJ, et al. Comparison of five antimicrobial regimens for treatment of mild to moderate inflammatory facial acne vulgaris in the community: randomised controlled trial. Lancet. 2004;364(9452):2188-95.

Tan AW, Tan HH. Acne vulgaris: a review of antibiotic therapy. Expert Opin Pharmacother. 2005;6(3):409-18.

Cunliffe WJ, Meynadier J, Alirezai M, et al. Is combined oral and topical therapy better than oral therapy alone in patients with moderate to moderately severe acne vulgaris? A comparison of the efficacy and safety of lymecycline plus adapalene gel 0.1%, versus lymecycline plus gel vehicle. J Am Acad Dermatol. 2003;49(3 Suppl):S218-26.

Leyden JJ. A review of the use of combination therapies for the treatment of acne vulgaris. J Am Acad Dermatol. 2003;49(3 Suppl):S200-10.

Published
2012-12-31
How to Cite
JA., GP., & BR. (2012). Oral antibiotics in acne vulgaris: therapeutic response over 5 year. Malaysian Family Physician, 5(3), 4. Retrieved from https://www.e-mfp.org/ojs3/index.php/MFP/article/view/61
Section
Original Articles