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Acne Treatment in Adults: is it done properly ?

Duration of oral antibiotic therapy for the treatment of adult acne: a retrospective analysis investigating adherence to guideline recommendations and opportunities for cost-savings.
Straight CE, Lee YH, Liu G, Kirby JS.
J Am Acad Dermatol. 2015 May;72(5):822-7. doi: 10.1016/j.jaad.2015.01.048. Epub 2015 Mar 7.

-Acne is one of the common disorders of the skin persisting in 10% of women over the age of 40.
-Treatments include local or systemic treatments and because of adults affected tend to be childbearing women, it is often difficult to prescribe oral isotretinoin.
-So the preferred treatment is a topical therapy, with or without the use of aral antibiotics; sometimes adjunctive physical treatments such as chemical peels and blue ligh led therapy can be useful.

Oral antibiotics include tetracyclines, doxycycline, minocycline, erythromycin and in some cases sulfamethoxazole/ trimethoprim is used.
Topical retinoids are recommended to be used in conjunction (in non-pregnant females) and should be used as a maintenance therapy after stopping antibiotics.

Guidelines are quite clear and antibiotic treatment should NOT be used for more than 3 months (6 according to some). Treatment should be combined with topical retinoids.

-In this retrospective US study published in the Journal of American Academy of Dermatology (JAAD)
-16488 individuals were analyzed including 13257 women with a mean age of 32
-minocycline and doxycycline were the most prescribed antibiotics, and were prescribed for 125 and 93 days respectively

Results
-84.5% of antibiotics followed the course duration according to guidelines
-69% were NOT combined with antibiotics
Comment:
-even if the therapy is used for too long, it may be because the stronger treatment is not always adequate: this is often the case of oral isotretinoin in adult potentially pregnant women.
-the results are statistics and do not take into account the individual patient