title: Views of oral antibiotics and advice seeking about acne: a qualitative study of online discussion forums.
abstract: BACKGROUND
  Acne vulgaris is common and can significantly impair quality of life, yet little is known about patients' understanding of acne and its treatments. Oral antibiotics are widely used for acne despite concerns about antibiotic resistance. People are increasingly turning to online discussion forums for advice, and information on these sites may influence health beliefs and treatment adherence.
  
  
  OBJECTIVE
  To explore understandings about the use of oral antibiotics for acne and advice shared among messages posted on online forums.
  
  
  METHODS
  We systematically searched for online forums and identified four where acne was frequently discussed. Discussion threads relating to oral antibiotics were analysed thematically.
  
  
  RESULTS
  We extracted 136 pages of data comprising 65 discussions among 294 participants. We found a wide range of perceptions around effectiveness of antibiotics for acne and concerns about adverse effects. The delayed onset of action of antibiotics was a source of frustration and compounded dissatisfaction with healthcare providers, who were perceived by people as 'fobbing them off' with prolonged courses of ineffective treatment. Advice ranged from when to ask for or insist on referral to use of costly cleansers. Forum posts related to a wide range of severities, from 'spots' to severe acne, which may make it confusing for users to assess appropriateness of information.
  
  
  CONCLUSIONS
  Online forums offer opinions that could confuse patients, or lead to early abandonment of treatments, challenging consultations and patient dissatisfaction. Users expressed frustration about the delayed onset of action of antibiotics for acne, perceptions of only temporary effectiveness and adverse effects.
authors.affiliation: Primary Care and Population Sciences, University of Southampton, Aldermoor Health Centre, Southampton, SO16 5ST, U.K.
authors.forename: M
authors.identifier: http://orcid.org/0000-0001-7264-5260
authors.initials: M
authors.lastname: Santer
authors.affiliation: Primary Care and Population Sciences, University of Southampton, Aldermoor Health Centre, Southampton, SO16 5ST, U.K.
authors.forename: D
authors.initials: D
authors.lastname: Chandler
authors.affiliation: Primary Care and Population Sciences, University of Southampton, Aldermoor Health Centre, Southampton, SO16 5ST, U.K.
authors.forename: M
authors.initials: M
authors.lastname: Lown
authors.affiliation: Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, U.K.
authors.forename: N A
authors.initials: NA
authors.lastname: Francis
authors.affiliation: Primary Care and Population Sciences, University of Southampton, Aldermoor Health Centre, Southampton, SO16 5ST, U.K.
authors.forename: I
authors.initials: I
authors.lastname: Muller
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy* / Q000523:psychology; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001294:Attitude to Health; D017144:Focus Groups; D006801:Humans; D020407:Internet; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic / Q000379:methods / Q000592:standards; D010465:Perception; D061108:Social Media; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents