Efficacy of rifampin-moxifloxacin-metronidazole combination therapy in hidradenitis suppurativa.
BACKGROUND
Antibiotics have been shown to improve hidradenitis suppurativa (HS) patients but complete remission is rare using these treatments.


OBJECTIVE
To assess the efficacy and safety of a combination of oral rifampin, moxifloxacin and metronidazole in long-lasting refractory HS.


METHODS
We retrospectively studied 28 consecutive HS patients including 6, 10 and 12 Hurley stage 1, 2 and 3 patients, respectively. Complete remission, defined as a clearance of all inflammatory lesions including hypertrophic scars, was the main outcome criterion of the study.


RESULTS
Complete remission was obtained in 16 patients, including 6/6, 8/10 and 2/12 patients with Hurley stage 1, 2 and 3, respectively (p=0.0004). The median duration of treatment to obtain complete remission was 2.4 (range 0.9-6.5) and 3.8 months (range 1.6-7.4) in stage 1 and 2 patients, respectively, and 6.2 and 12 months in the 2 stage 3 patients. Main adverse events of the treatments were gastrointestinal disorders (64% of patients) and vaginal candidiasis (35% of females). Reversible tendinopathy and hepatitis occurred in 4 and 1 patient, respectively.


CONCLUSIONS
Complete remission of refractory HS can be obtained using broad-spectrum antibiotics and Hurley staging is a prognostic factor of response to the treatment.
Université Paris Descartes, Faculté de Médecine Paris Descartes, Paris, France. olivier.join-lambert@inserm.fr
Olivier
O
Join-Lambert
Hélène
H
Coignard
Jean-Philippe
JP
Jais
Hélène
H
Guet-Revillet
Sylvain
S
Poirée
Sylvie
S
Fraitag
Vincent
V
Jullien
Florence
F
Ribadeau-Dumas
Jacques
J
Thèze
Anne-Sophie
AS
Le Guern
Sylvie
S
Behillil
Anne
A
Leflèche
Patrick
P
Berche
Paul Henri
PH
Consigny
Olivier
O
Lortholary
Xavier
X
Nassif
Aude
A
Nassif
D000328:Adult; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000904:Antibiotics, Antitubercular / Q000009:adverse effects / Q000627:therapeutic use*; D001372:Aza Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D024841:Fluoroquinolones; D017497:Hidradenitis Suppurativa / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008795:Metronidazole / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D000077266:Moxifloxacin; D011379:Prognosis; D011804:Quinolines / Q000009:adverse effects / Q000627:therapeutic use*; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D012293:Rifampin / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
D000890:Anti-Infective Agents; D000904:Antibiotics, Antitubercular; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D008795:Metronidazole; D000077266:Moxifloxacin; D012293:Rifampin