Antibiotic and Microbiological Profiles in Hidradenitis Suppurativa

To investigate the results of swab cultures obtained from lesions of patients with hidradenitis suppurativa (HS) and their antibiotic resistance.

An observational study. Place and Duration of the Study: Department of Dermatology and Venereology, Ankara Etlik City Hospital, Ankara, Turkiye, from October 2022 to May 2024.

A total of 123 patients aged ≥18 years diagnosed with HS, from whom swab cultures were taken from purulent lesions, were included in this study. Data on the Hurley clinical staging system of HS, disease duration, previous antibiotic use, the areas of lesions from which cultures were obtained, and the results of culture and antibiotic resistance were recorded. Descriptive statistical methods were used to evaluate the data.

The mean age was 39.1 ± 13.7 years in 35 (28.5%) female and 88 (71.5%) male patients. The mean duration of HS was 156 ± 140 months. Patients were mainly classified as Hurley 2 (n = 73, 59.3%), Hurley 3 (n = 33, 26.8%), and Hurley 1 (n = 17, 13.8%). A total of 113 patients (91.9%) had a history of antibiotic use. The highest growth in culture was observed in lesions obtained from the axillary region (n = 75, 61%). Skin flora were observed in swab cultures in 94 patients (76.4%), and non-skin flora grew in 29 patients (23.6%). Among the 29 patients, the most common was Staphylococcus aureus (n = 11, 37.9%). The highest rates of resistance were observed to ampicillin (n = 11, 8.9%), clindamycin (n = 7, 5.7%), and penicillin G (n = 7, 5.7%). Antibiotic resistance was detected in the antibiograms of 23 patients with non-skin flora. The highest resistance rates were observed to ampicillin (n = 11, 47.8%), clindamycin (n = 7, 30.4%), and penicillin G (n = 7, 30.4%).

Given the predominance of skin flora in HS lesions, biological agents may offer more effective long-term management than antibiotics for patients with HS.

Antibiotic treatment, Antibiotic resistance, Hidradenitis suppurativa, Biologic treatment.