Antibiotic treatment of acne may be associated with upper respiratory tract infections

To determine if the long-term use of antibiotics for the treatment of acne results in an increase in either of 2 common infectious illnesses: upper respiratory tract infections (URTIs) or urinary tract infections.

Retrospective cohort study.

General Practice Research Database of the United Kingdom, London, England, from 1987 to 2002.

Patients with a diagnosis of acne.

The onset of either a URTI or a urinary tract infection.

Of 118 496 individuals with acne (age range, 15-35 years) who were identified in the General Practice Research Database, 84 977 (71.7%) received a topical or oral antibiotic (tetracyclines, erythromycin, or clindamycin) for treatment of their acne and 33 519 (28.3%) did not. Within the first year of observation, 18 281 (15.4%) of the patients with acne had at least 1 URTI, and within that year, the odds of a URTI developing among those receiving antibiotic treatment were 2.15 (95% confidence interval, 2.05-2.23; P<.001) times greater than among those who were not receiving antibiotic treatment. Multiple additional analyses, which were conducted to show that this effect was not an artifact of increased health care-seeking behavior among our cohorts, included comparing the cohorts of patients with acne with a cohort of patients with hypertension and the likelihood of developing a urinary tract infection.

Patients with acne who were receiving antibiotic treatment for acne were more likely to develop a URTI than those with acne who were not receiving such treatment. The true clinical importance of our findings will require further investigation.