title: [Bacterial resistance in acne? A meta-analysis of the controversy].
abstract: BACKGROUND
  Acne is one of the dermatological pathologies with the highest incidence around the world. It is a multifactorial disease and its treatment can be complex. Propionibacterium acnes play a key role in the inflammation of this dermatosis. Topical antibiotics, including mainly erythromycin and clindamycin, have been used, but there is controversy over their use due to the widely documented bacterial resistance. For this reason a meta-analysis of the publications over the past 10 years is presented in order to confirm this hypothesis.
  
  
  METHODS
  A search was made of the publications over the past 10 years that included the results of antibiogams of patients with acne. MeSH type searches were performed with the terms "acne vulgaris", "Propionibacterium acnes", "topical administration", "treatment", "erythromycin", "clindamycin", "nadifloxacin", "antibacterial agent", "bacterial drug resistance" in PubMed, Ovid, EBSCO, Cochrane, ScienceDirect and ClinicalKey meta-searches.
  
  
  RESULTS
  A total of 13 articles were found that met the inclusion criteria. The mean odds ratio (OR 1.24, 95% CI) of the articles showed a slight tendency toward resistance of Propionibacterium acnes.
  
  
  CONCLUSIONS
  An increase in bacterial resistance to topical erythromycin and clindamycin can be confirmed, thus the use of these antibiotics is recommended in selective cases for short periods, and in combination with benzoyl peroxide for the best clinical outcome in patients with acne vulgaris.
authors.affiliation: Facultad de Ciencias de la Salud, Universidad Anáhuac México Norte, Huixquilucan, México. Electronic address: mariana.alvasa@gmail.com.
authors.forename: Mariana
authors.initials: M
authors.lastname: Alvarez-Sánchez
authors.affiliation: Facultad de Ciencias de la Salud, Universidad Anáhuac México Norte, Huixquilucan, México.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Rodríguez-Ayala
authors.affiliation: Servicio de Dermatología, Hospital General de México, México, D.F., México.
authors.forename: Rosa María
authors.initials: RM
authors.lastname: Ponce-Olivera
authors.affiliation: Servicio de Dermatología, Hospital General de México, México, D.F., México.
authors.forename: Andrés
authors.initials: A
authors.lastname: Tirado-Sánchez
authors.affiliation: Servicio de Dermatología, Hospital General de México, México, D.F., México.
authors.forename: María Ivonne
authors.initials: MI
authors.lastname: Arellano-Mendoza
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D000279:Administration, Cutaneous; D001585:Benzoyl Peroxide / Q000008:administration & dosage / Q000494:pharmacology; D002981:Clindamycin / Q000008:administration & dosage / Q000494:pharmacology; D004338:Drug Combinations; D024881:Drug Resistance, Bacterial; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D004917:Erythromycin / Q000008:administration & dosage / Q000494:pharmacology; D006801:Humans; D008826:Microbial Sensitivity Tests; D016017:Odds Ratio; D011425:Propionibacterium acnes / Q000187:drug effects* / Q000302:isolation & purification; D017192:Skin Diseases, Bacterial / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D004338:Drug Combinations; D002981:Clindamycin; D004917:Erythromycin; D001585:Benzoyl Peroxide
keywords: Acne vulgaris; Bacterial resistance; Meta-analysis; Metaanálisis; Propionibacterium acnes; Resistencia bacteriana