[General antibiotic therapy in acne]

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Brigitte Dréno1

  • 1Clinique dermatologique Centre hospitalier universitaire Hôtel-Dieu, 44093 Nantes. bdreno@wanadoo.fr

La Revue Du Praticien
|June 11, 2002
PubMed

Insights

Systemic antibiotics are key for moderate-to-severe inflammatory acne, targeting inflammatory lesions and Propionibacterium acnes. Guidelines are essential due to increasing antibiotic resistance.

Area of Science:

  • Dermatology
  • Microbiology
  • Pharmacology

Context:

  • Moderate-to-severe inflammatory acne requires systemic treatment.
  • Antibiotic therapy is a primary treatment modality for inflammatory acne.
  • Propionibacterium acnes plays a role in acne pathogenesis.

Purpose:

  • To outline the role and considerations of systemic antibiotic therapy in managing acne vulgaris.
  • To review preferred antibiotic agents, mechanisms of action, and potential alternatives.
  • To highlight the emergence of antibiotic resistance and the need for treatment guidelines.

Summary:

  • Systemic antibiotics, primarily tetracyclines, are indicated for moderate-to-severe inflammatory acne, targeting inflammatory lesions and reducing Propionibacterium acnes.
  • Antibiotics offer anti-inflammatory effects and are effective against papules and pustules, with macrolides, co-trimoxazole, and trimethoprim as alternatives.
  • While severe side effects are uncommon, increasing antibiotic resistance necessitates careful patient selection and adherence to general guidelines for oral antibiotic use in acne.

Impact:

  • Informs clinical practice regarding appropriate systemic antibiotic selection and usage for acne.
  • Highlights the growing challenge of antibiotic resistance in Propionibacterium acnes, emphasizing the need for judicious antibiotic stewardship.
  • Underscores the importance of established guidelines to optimize therapeutic outcomes and minimize the development of resistance in acne management.

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