AcneFeatured ArticlesThe Latest

Oral Tetracyclines and Acne: A Systematic Review for Dermatologists

By January 19, 2021March 15th, 2021No Comments

Featured Article

Featured Article

Oral tetracyclines are the most widely prescribed systemic antibiotic for acne. Synthesis of efficacy and safety of traditional and novel oral tetracyclines is highly informative to clinical practice. The authors conducted a systematic search of PubMed to identify large interventional and observational studies utilizing oral tetracyclines as an acne treatment.

Oral tetracyclines are the most widely prescribed systemic antibiotic for acne. Synthesis of efficacy and safety of traditional and novel oral tetracyclines is highly informative to clinical practice. The authors conducted a systematic search of PubMed to identify large interventional and observational studies utilizing oral tetracyclines as an acne treatment.

April W. Armstrong MD MPH, Joshua Hekmatjah BS, Leon H. Kircik MD

Acne vulgaris is a common skin disease affecting up to 70% of the population during their lifetime.  Cutibacterium acnes is the primary target of acne pathogenesis, and oral antibiotics, namely oral tetracyclines, have been the mainstay of systemic acne treatment for decades. In addition, oral tetracyclines possess an indirect anti-inflammatory effect against acne. Oral tetracyclines are an important part of the acne treatment regimen, and substantial evidence exists for their efficacy and safety for use in inflammatory acne.

Oral tetracyclines demonstrate bacteriostatic (inhibiting bacterial growth) effects against C. acnes; however, some tetracyclines also exhibit bacteriostatic effects on beneficial commensal organisms of the gut. This broad-spectrum effect can lead to a less diverse gut microbiome. Disruptions in the symbiotic relationship between the gut microbiome and the host have been associated with chronic diseases, such as obesity and inflammatory bowel disease (IBD).  Although a compositional definition of an ideal gut microbiome does not exist, greater microbial diversity is important for protection from pathogens, nutrient supply, and vitamin production.

While oral tetracyclines are widely prescribed for acne, a gap exists in synthesizing the most recent data on the efficacy and safety of these agents. We conducted a systematic review of the efficacy and safety of common oral tetracyclines (sarecycline, doxycycline, minocycline, and tetracycline) used for acne.

To determine the efficacy and safety of oral tetracyclines for acne, we followed the Preferred Reporting Items for Systematic Reviews guidelines and performed a systematic review using PubMed and Embase. Our search included published articles from January 1960 to April 2020, and our search criteria included the following: (“Acne”[MeSH] OR “Acne Vulgaris”[MeSH]) OR “acne vulgaris/drug therapy”[MeSH Major Topic]) AND tetracyclines [MeSH Terms].

Among their many additional suggestions, the authors offer insight into financial considerations, office medical record policies and procedures, how much to stock of various emergency supplies and more.

“We are hopeful that this provides at least a template of items for consideration and implementation across the various practice situations and emergencies and mitigates the reoccurrence of difficult lessons learned from the COVID-19 pandemic,” they write.

Read Article Now
Articles Cited in this Post

 

Oral Tetracyclines and Acne: A Systematic Review for Dermatologists

Oral tetracyclines are the most widely prescribed systemic antibiotic for acne. Synthesis of efficacy and safety of traditional and novel oral tetracyclines is highly informative to clinical practice. We conducted a systematic search of PubMed to identify large interventional and observational studies utilizing oral tetracyclines as an acne treatment. We identified 13 articles meeting inclusion for this review, which represented 226,019 pediatric and adult acne patients. Oral tetracyclines that were included in this systematic review were sarecycline (a novel narrow-spectrum tetracycline), doxycycline, minocycline, and tetracycline. Based on shared and divergent outcome measures, different oral tetracyclines were variably effective against facial acne. Sarecycline also demonstrated efficacy in truncal acne. Members of the oral tetracycline class also differed in their ability to minimize antibiotic resistance and gut dysbiosis.
Read More

You May Also Like

SANOVAWORKS TO MATCH CMMP GRANTS FOR MEDICAL STUDENTS

| Derm Community, Featured Articles, JDD Highlights | No Comments
SanovaWorks has developed a partnership with and in support of Comprehensive Medical Mentoring Program. We are happy to announce that SanovaWorks will match the CMMP Medical Student Grant fund, which was…
Dyshidrotic eczema picture on the sole of the foot

New Treatment for Dyshidrotic Eczema

| Featured Articles, JDD Highlights | No Comments
Struggling with how to treat dyshidrotic eczema of the hands, palms, fingers or feet? We explore the use of a new medication in the treatment of dyshidrotic eczema and common…

Survey provides insight into factors that influence men’s sunscreen use

| Featured Articles, Home page feature, Skin Cancer, The Latest | No Comments
While men are more likely than women to develop skin cancer, a recent survey indicates most do not use sunscreen on a daily basis. Heather Onorati While men are more…

Leave a Reply