title: Topical and oral antibiotics for acne vulgaris.
abstract: Antibiotics, both oral and topical, have been an integral component of the management of acne vulgaris (AV) for approximately 6 decades. Originally thought to be effective for AV due to their ability to inhibit proliferation of Propionibacterium acnes, it is now believed that at least some antibiotics also exert anti-inflammatory effects that provide additional therapeutic benefit. To add, an increase in strains of P acnes and other exposed bacteria that are less sensitive to antibiotics used to treat AV have emerged, with resistance directly correlated geographically with the magnitude of antibiotic use. Although antibiotics still remain part of the therapeutic armamentarium for AV treatment, current recommendations support the following when used to treat AV: 1) monotherapy use should be avoided; 2) use benzoyl peroxide concomitantly to reduce emergence of resistant P acnes strains; 3) oral antibiotics should be used in combination with a topical regimen for moderate-to-severe inflammatory AV; and 4) use oral antibiotics over a limited duration to achieve control of inflammatory AV with an exit plan in place to discontinue their use as soon as possible. When selecting an oral antibiotic to treat AV, potential adverse effects are important to consider.
authors.affiliation: Adjunct Clinical Professor (Dermatology), Touro University Nevada, Henderson, Nevada, USA.|Del Rosso Dermatology Research, LLC, Las Vegas, Nevada, USA. jqdelrosso@yahoo.com.
authors.forename: James Q
authors.initials: JQ
authors.lastname: Del Rosso
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy*; D000279:Administration, Cutaneous; D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001585:Benzoyl Peroxide / Q000008:administration & dosage*; D003879:Dermatologic Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D006801:Humans; D011425:Propionibacterium acnes / Q000187:drug effects; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D003879:Dermatologic Agents; D001585:Benzoyl Peroxide