In an effort to provide guidance to prescribers and encourage further research on the risk of antibiotic resistance in acne treatment, JAMA Dermatology published a clinical evidence synopsis (online June 21, 2017). Brandon L. Adler, MD, et al, reviewed five clinical trials published in 1987-2002 and 2007-2008. They found evidence that the widespread use of bacteriostatic antibiotics (topical erythromycin and clindamycin and oral tetracyclines) may encourage the emergence of antibiotic-resistant strains of P acnes, via point mutations.
Some of the key findings included resistant P acnes found on the skin of untreated contacts of acne patients prescribed antibiotics. In addition, the use of topical antibiotics has been associated with resistance in staphylococcus aureus.
In one retrospective cohort of more than 100,000 acne patients, subjects treated with topical and/or oral antibiotics for at least six weeks were significantly more likely to develop upper respiratory infections during one year follow-up than patients who had not received antibiotics.
To help reduce antibiotic usage in acne treatment, the American Academy of Dermatology (AAD) recommends coadministration...