Antibiotic Resistance and Acne: Where We Stand and What the Future Holds

June 2014 | Volume 13 | Issue 6 | Supplement Individual Articles | 66 | Copyright © June 2014


Whitney P. Bowe MD

SUNY Downstate College of Medicine, Brooklyn, NY

Third, when certain probiotic strains are placed in contact with epithelial cells, they are capable of inhibiting inflammatory pathways and thus the production of inflammatory cytokines.14 As chronic inflammation plays a major role in acne, a natural immunomodulator could play a needed role.

CONCLUSION

Antibiotics have played a leading role in the treatment of acne for decades. However, recent issues surrounding resistance force us to question how much longer we can count on these drugs, and whether or not they will maintain their front-line role as safe, effective treatments. It is our responsibility to take whatever measures we can to limit the development of further antibiotic resistance, and those measures are reviewed here. While we fight to maintain the clinical value of antibiotics, we must also continue to search for novel approaches to the treatment of acne. An ongoing search for unique treatments that can be used in concert with or as alternatives to antibiotics will allow us to best prepare ourselves for what the future has in store.

DISCLOSURES

Whitney P. Bowe MD has served as a consultant for Johnson & Johnson Consumer Companies Inc, on an advisory panel for Galderma Labs, and as a consultant for Procter and Gamble.

REFERENCES

  1. Cookson C. Financial Times. http://www.ft.com/intl/cms/s/0/172341bc-d42811e2-a464-00144feab7de.html#axzz2z5sUHxfw. Accessed April 16, 2014.
  2. World Health Organization. http://www.who.int/drugresistance/activities/ wha66_side_event/en/. Accessed April 16, 2014.
  3. Symphony Health PHAST Monthly Prescription.
  4. Rosen T. Antibiotic resistance: an editorial review with recommendations. J Drugs Dermatol. 2011;10(7):724-733.
  5. Ross JI, Snelling AM, Eady EA, et al. Phenotypic and genotypic characterization of antibiotic-resistant Propionibacterium acnes isolated from acne patients attending dermatology clinics in Europe, the U.S.A., Japan and Australia. Br J Dermatol. 2001;144(2):339-346.
  6. Del Rosso JQ, Kim G. Optimizing use of oral antibiotics in acne vulgaris. Dermatol Clin. 2009;27(1):33-42.
  7. Del Rosso JQ, Leyden JJ, Thiboutot D, Webster GF. Antibiotic use in acne vulgaris and rosacea: clinical considerations and resistance issues of significance to dermatologists. Cutis. 2008;82(2 suppl 2):s5-s12.
  8. Patel M, Bowe WP, Heughebaert C, Shalita AR. The development of antimicrobial resistance due to the antibiotic treatment of acne vulgaris: a review. J Drugs Dermatol. 2010;9(6):655-664.
  9. Gold LS, Cruz A, Eichenfield L, et al. Effective and safe combination therapy for severe acne vulgaris: a randomized, vehicle-controlled, double-blind study of adapalene 0.1%-benzoyl peroxide 2.5% fixed-dose combination gel with doxycycline hyclate 100 mg. Cutis. 2010;85(2):94-104.
  10. Poulin Y, Sanchez NP, Bucko A, et al. A 6-month maintenance therapy with adapalene-benzoyl peroxide gel prevents relapse and continuously improves efficacy among patients with severe acne vulgaris: results of a randomized controlled trial. Br J Dermatol. 2011;164(6):1376-1382.
  11. Tan J, Stein Gold L, Schlessinger J, et al. Short-term combination therapy and long-term relapse prevention in the treatment of severe acne vulgaris. J Drugs Dermatol. 2012;11(2):174-180.
  12. Leyden JJ, Preston N, Osborn C, Gottschalk RW. In-vivo effectiveness of adapalene 0.1%/benzoyl peroxide 2.5% gel on antibiotic-sensitive and resistant Propionibacterium acnes. J Clin Aesthet Dermatol. 2011;4(5):22-26.
  13. Thiboutot D, Gollnick H, Bettoli V, et al. New insights into the management of acne: an update from the Global Alliance to Improve Outcomes in Acne group. J Am Acad Dermatol. 2009;60(suppl 5):s1-s50.
  14. Bowe WP. Probiotics in acne and rosacea. Cutis. 2013;92:6-7.

AUTHOR CORRESPONDENCE

Whitney P. Bowe MDwpbowe@gmail.com