November 12, 2015
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Antibiotic treatment duration for severe acne exceeded recommendations

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Antibiotic treatment for patients with severe acne who eventually received isotretinoin exceeded the recommended duration, according to recently published study results.

“Our study suggests that physicians need to recognize within weeks, not months, when patients are failing to respond to antibiotic therapy in cases of severe acne,” researcher Seth Orlow, MD, PhD, of New York University Langone Medical Center, said in a press release.

Researchers conducted a retrospective chart review of 5,053 patients aged 12 years or older with inflammatory or nodulocystic acne who were evaluated from 2005 to 2014 at the faculty group practice at the Ronald O. Perelman Department of Dermatology at New York University Langone Medical Center. The study included 137 patients (58.4% male) who received isotretinoin during the study period and received antibiotics for 30 days. Most patients (74.5%) had nodulocystic acne and the remainder had inflammatory acne.

The most commonly prescribed antibiotic was minocycline, comprising 72.5% of prescriptions. An average of 1.96 antibiotic classes were used per person. The mean duration of antibiotic use was 331 days. Antibiotics were prescribed to 15.3% of patients for 3 months or less, 64.2% of patients for 6 months or longer and 33.6% of patients for 1 year or longer.

There was nearly a statistical difference between mean antibiotic duration of 283.1 days for patients treated at the study site only compared with 380.2 days for patient who received antibiotics form more than one institution (P = .054).

Initiation of isotretinoin occurred at a mean age of 19.6 years, with male patients significantly younger (average age, 18.4 years) compared with female patients (average age, 21.2 years; P = .008).

“Expert groups and global committees have repeatedly made recommendations to limit the use of systemic antibiotics,” the researchers wrote. “Three months is the most commonly used cut-off point for limitation the duration of antibiotics in acne.”

“We found that patients who eventually received isotretinoin had extended exposure to antibiotics, exceeding expectations,” the researchers concluded. “Early recognition of patients who are failing antibiotics after 6 to 8 weeks and who will likely require treatment with isotretinoin will help decrease antibiotic use.”  – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.