title: A retrospective analysis of the duration of oral antibiotic therapy for the treatment of acne among adolescents: investigating practice gaps and potential cost-savings.
abstract: BACKGROUND
  Duration of oral antibiotic therapy in acne has not been widely studied. Recent guidelines suggest it should be limited to 3 to 6 months.
  
  
  OBJECTIVE
  We sought to compare the duration of oral antibiotic use with recent guidelines and determine the potential cost-savings related to shortened durations.
  
  
  METHODS
  This is a retrospective cohort study from the MarketScan Commercial Claims and Encounters database. Claims data were used to determine duration and costs of antibiotic therapy.
  
  
  RESULTS
  The mean course duration was 129 days. The majority (93%) of courses were less than 9 months. Among the 31,634 courses, 18,280 (57.8%) did not include concomitant topical retinoid therapy. The mean (95% confidence interval) duration with and without topical retinoid use was 133 (131.5-134.7) days and 127 (125.4-127.9) days, respectively. The mean excess direct cost of antibiotic treatment for longer than 6 months was $580.99/person.
  
  
  CONCLUSIONS
  Claims cannot be attributed to a specific diagnosis or provider. The database does not provide information on acne severity.
  
  
  CONCLUSIONS
  Duration of antibiotic use is decreasing when compared with previous data. However, 5547 (17.53%) courses exceeded 6 months, highlighting an opportunity for reduced antibiotic use. If courses greater than 6 months were shortened to 6 months, savings would be $580.99/person.
authors.affiliation: Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania. Electronic address: ylee1@hmc.psu.edu.
authors.forename: Young H
authors.initials: YH
authors.lastname: Lee
authors.affiliation: Division of Health Services Research, Department of Public Health Sciences, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Guodong
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Diane M
authors.initials: DM
authors.lastname: Thiboutot
authors.affiliation: Division of Health Services Research, Department of Public Health Sciences, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Leslie
authors.affiliation: Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Joslyn S
authors.initials: JS
authors.lastname: Kirby
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy* / Q000191:economics; D000284:Administration, Oral; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000191:economics; D017046:Cost Savings; D017281:Cost of Illness; D003880:Dermatology / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000592:standards; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: acne treatment; acne vulgaris; costs; oral antibiotics; topical retinoids; treatment guidelines