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Antibiotic resistance in acne: changes, consequences and concerns.

A S Karadag1, M Aslan Kayıran1, C-Y Wu2,3

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Antibiotic resistance in acne is a growing concern, with increasing resistance to topical treatments like erythromycin and clindamycin. While tetracycline resistance remains low, newer macrolides show rising resistance, impacting acne treatment outcomes.

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Area of Science:

  • Dermatology
  • Microbiology
  • Pharmacology

Background:

  • Antibiotic resistance in acne vulgaris has been a significant dermatological issue since the 1980s.
  • Observed since the 1970s, resistance patterns vary globally, affecting antimicrobial efficacy.
  • Topical erythromycin and clindamycin resistance are persistent worldwide challenges.

Purpose of the Study:

  • To review the current landscape of antibiotic resistance in acne.
  • To highlight regional variations in resistance rates and antimicrobial types.
  • To discuss the implications of increasing antimicrobial resistance in acne management.

Main Methods:

  • Literature review of antibiotic resistance trends in acne.
  • Analysis of resistance patterns for various antimicrobial classes.
  • Examination of clinical and microbiological consequences of resistance.

Main Results:

  • Resistance to topical erythromycin and clindamycin remains a global problem.
  • Systemic tetracycline resistance has been low in the last decade.
  • Increasing resistance rates observed for newer macrolides like azithromycin and clarithromycin.

Conclusions:

  • Antibiotic resistance in acne can lead to treatment failures and skin microbiota disruption.
  • Potential for opportunistic pathogen induction and dissemination of resistant strains exists.
  • Emergence of multiresistant strains and aggravated infections require ongoing monitoring.