Risk of Bacterial Resistance in Systemic Antibiotic Use for Acne

Antibiotics for acne continue to come with ambiguities concerning long-term use and antibiotic resistance. In a presentation at the recent American Academy of Dermatology (AAD) Annual Meeting, held March 25 to 29, in Boston, Massachusetts, Diane M. Thiboutot, MD, highlighted data on these issues and potential alternatives to some frequently used options.¹

Thiboutot is a professor of dermatology at the Pennsylvania State University College of Medicine, in Hershey.

Systemic antibiotics are recommended for moderate to severe acne management and forms of inflammatory acne resistant to topical alternatives, she said. Of the systemic antibiotic options, she noted that doxycycline and minocycline are more effective than tetracycline, however neither doxycycline nor minocycline is superior then the other.

Oral erythromycin and azithromycin should be limited to patients unable to use tetracyclines, like those who are pregnant or children under 8 years old. Additionally, erythromycin should be restricted as it holds an increased risk of bacterial resistance, according to Thiboutot.