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Updated: Jul 11, 2026

Implementation of In Vitro Drug Resistance Assays: Maximizing the Potential for Uncovering Clinically Relevant Resistance Mechanisms
08:46

Implementation of In Vitro Drug Resistance Assays: Maximizing the Potential for Uncovering Clinically Relevant Resistance Mechanisms

Published on: December 9, 2015

The impact and importance of resistance

Emil Tanghetti1

  • 1Department of Dermatology, University of California, Davis, USA.

Cutis
|September 11, 2007
PubMed

Insights

Antibiotic resistance in Propionibacterium acnes is a growing concern for acne treatment. Combination therapy with benzoyl peroxide (BPO) is crucial for maintaining antibiotic effectiveness against acne.

Area of Science:

  • Dermatology
  • Microbiology
  • Pharmacology

Background:

  • Antibiotic resistance in bacteria emerged shortly after antibiotic introduction.
  • Propionibacterium acnes (P. acnes) has shown decreased sensitivity to antibiotics since the 1970s, impacting acne treatment efficacy.
  • This resistance leads to reduced treatment effectiveness and nonresponse in patients with acne.

Purpose of the Study:

  • To review recommendations for the optimal use of antibiotics in acne management.
  • To emphasize strategies for preserving the utility of antibiotics against P. acnes.
  • To evaluate the role of combination therapies in mitigating antibiotic resistance.

Main Methods:

  • Review of existing literature and clinical recommendations on antibiotic use in acne.
  • Analysis of the impact of combination therapy on P. acnes antibiotic resistance.
  • Assessment of the role of benzoyl peroxide (BPO) and retinoids in managing antibiotic resistance.

Main Results:

  • Combination therapy with benzoyl peroxide (BPO) is the most effective strategy to minimize antibiotic resistance development in P. acnes.
  • Retinoids are effective against acne pathogenetic mechanisms but do not prevent antibiotic resistance when used with topical antibiotics.
  • Clinical outcomes demonstrate decreased efficacy and nonresponse to antibiotic monotherapy due to resistance.

Conclusions:

  • Judicious use of antibiotics is essential for managing acne and combating resistance.
  • Combination therapy, particularly with benzoyl peroxide (BPO), is recommended to preserve antibiotic efficacy.
  • Retinoids should be considered for their direct acne-fighting mechanisms, but not as a primary strategy for preventing antibiotic resistance.

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