title: Efficacy of ertapenem in severe hidradenitis suppurativa: a pilot study in a cohort of 30 consecutive patients.
abstract: OBJECTIVE
  Hidradenitis suppurativa (HS) is an inflammatory skin disease typically localized in the axillae and inguinal and perineal areas. In the absence of standardized medical treatment, severe HS patients present chronic suppurative lesions with polymicrobial anaerobic abscesses. Wide surgery is the cornerstone treatment of severe HS, but surgical indications are limited by the extent of lesions. Intravenous broad-spectrum antibiotics may help control HS, but their efficacy is not documented. This study was designed to assess the efficacy of a 6 week course of ertapenem (1 g daily) and of antibiotic consolidation treatments for 6 months (M6) in severe HS.
  
  
  METHODS
  Thirty consecutive patients with severe HS were retrospectively included in this study. The clinical severity of HS was assessed using the Sartorius score, which takes into account the number and severity of lesions.
  
  
  RESULTS
  The median (IQR) Sartorius score dropped from 49.5 (28-62) at baseline to 19.0 (12-28) after ertapenem (P < 10(-4)). Five patients were lost to follow-up thereafter. At M6 the Sartorius score further decreased for the 16 patients who received continuous consolidation treatments, since 59% of HS areas reached clinical remission at M6 (i.e. absence of any inflammatory symptoms, P < 10(-4)). Nine patients interrupted or received intermittent consolidation treatments due to poor observance or irregular follow-up. Their Sartorius score stopped improving or returned to baseline. No major adverse event occurred.
  
  
  CONCLUSIONS
  Ertapenem can dramatically improve severe HS. Consolidation treatments are needed to further improve HS and are mandatory to prevent relapses. Combined with surgery, optimized antibiotic treatments may be promising in severe HS.
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France Laboratoire de Microbiologie, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France Centre d'Infectiologie Necker-Pasteur, Paris, France Inserm U1151, eq. 11, Paris, France olivier.join-lambert@inserm.fr.
authors.forename: Olivier
authors.initials: O
authors.lastname: Join-Lambert
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France Centre d'Infectiologie Necker-Pasteur, Paris, France Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Coignard-Biehler
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France Service d'Informatique Médicale et de Biostatistiques, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France Inserm U1138, eq. 22, Paris, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Jais
authors.affiliation: Centre d'Infectiologie Necker-Pasteur, Paris, France Service de Dermatologie, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Bobigny, France Institut Pasteur, Centre Médical, Paris, France.
authors.forename: Maïa
authors.initials: M
authors.lastname: Delage
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France Laboratoire de Microbiologie, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France Centre d'Infectiologie Necker-Pasteur, Paris, France Inserm U1151, eq. 11, Paris, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Guet-Revillet
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France Service de Radiologie Adulte, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Poirée
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France Inserm U1163, Laboratory of Genetic Skin Diseases: From Disease Mechanism to Therapies, Imagine Institute, Paris, France.
authors.forename: Sabine
authors.initials: S
authors.lastname: Duchatelet
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France Inserm U663, Paris, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Jullien
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France Inserm U1163, Laboratory of Genetic Skin Diseases: From Disease Mechanism to Therapies, Imagine Institute, Paris, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Hovnanian
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France Centre d'Infectiologie Necker-Pasteur, Paris, France Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Lortholary
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France Laboratoire de Microbiologie, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France Centre d'Infectiologie Necker-Pasteur, Paris, France Inserm U1151, eq. 11, Paris, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Nassif
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Paris, France Centre d'Infectiologie Necker-Pasteur, Paris, France Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France Institut Pasteur, Centre Médical, Paris, France.
authors.forename: Aude
authors.initials: A
authors.lastname: Nassif
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy / Q000379:methods; D000077727:Ertapenem; D005260:Female; D017497:Hidradenitis Suppurativa / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013514:Surgical Procedures, Operative / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult; D047090:beta-Lactams / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D000077727:Ertapenem