title: Treating acne with antibiotic-resistant bacterial colonization.
abstract: BACKGROUND
  Acne is a chronic skin disorder of the pilosebaceous unit; it has a multifactorial pathogenesis. Propionibacterium acnes within the follicle is considered to be a triggering factor of inflammation in acne. Antibiotics have been the primary treatment against P. acnes for more than 40 years. However, a gradual increase in the prevalence of antibiotic-resistant strains of P. acnes has been observed.
  
  
  METHODS
  This review discusses the pathophysiology of antibiotic-resistant acne development. It focuses on strategies to minimize the development of resistance and, most importantly, confront the development of antibiotic-resistant acne. The literature search was conducted up to August 2010, using the search terms 'acne', 'antibiotic-resistant acne' and 'bacterial resistance'.
  
  
  CONCLUSIONS
  Antibiotic-resistant acne is a real phenomenon. Strategies to prevent and confront it should include not only the use of certain treatment regimens but also rational prescribing policies, combination therapies, use of antibacterial non-antibiotic agents and treatment options targeting all the pathogenetic components of acne. Benzoyl-peroxide-based treatment is the most evidence-based approach. Oral isotretinoin remains the most efficacious option for severe acne.
authors.affiliation: Dessau Medical Center, Departments of Dermatology, Venereology, Allergology and Immunology, Auenweg Dessau, Germany. christos.zouboulis@klinikum-dessau.de
authors.forename: Thrasivoulos
authors.initials: T
authors.lastname: Tzellos
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Zampeli
authors.forename: Evgenia
authors.initials: E
authors.lastname: Makrantonaki
authors.forename: Christos C
authors.initials: CC
authors.lastname: Zouboulis
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy* / Q000382:microbiology* / Q000503:physiopathology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001585:Benzoyl Peroxide / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D004359:Drug Therapy, Combination; D054884:Host-Pathogen Interactions; D006801:Humans; D015474:Isotretinoin / Q000627:therapeutic use; D011425:Propionibacterium acnes / Q000187:drug effects / Q000302:isolation & purification / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; D003879:Dermatologic Agents; D015474:Isotretinoin; D001585:Benzoyl Peroxide