Narrow-spectrum antibiotics viable treatment option for acne
The use of antibiotics for treatment of acne vulgaris has been around for decades. However, in recent years, the perception of antibiotics has changed due to the possibility for development of antibiotic resistance.
The use of antibiotics as a treatment for acne can be attributed to the drug’s anti-bacterial and anti-inflammatory properties to help with skin clearance. Tetracycline are the most commonly prescribed class of antibiotics, with some of the most popular oral medications including doxycycline, minocycline and newly approved sarecycline.
Perceptions about the use of oral antibiotics in acne have changed largely due to public concerns over the development of antibiotic resistance, causing dermatologists to think more about duration of antibiotic therapy and which drug has the least propensity for developing resistance.
the concern for patients developing antibiotic resistance can be contributed to a specific group of antibiotics — broad-spectrum antibiotics, defined as an antibiotic that targets a large variety of bacterial species. These types of antibiotics are concernable due to the possibility that they could harm some of the good bacterial species that make up the skin’s microbiome. Some of these broad-spectrum antibiotics include doxycycline, minocycline, tetracycline, azithromycin, amoxicillin, trimethoprim and sulfamethoxazole.
When antibiotic resistance occurs, the medication could possibly no longer help treat the patient’s acne, as well as alteration of the skin microbiome (microbial dysbiosis), and increased difficulty in treating infections.
However, narrow-spectrum antibiotics target fewer bacterial species, leading to decreased chance in developing antibiotic resistance. Some narrow-spectrum antibiotics include sarecycline, fidaxomicin, vancomycin and bedaquiline, with sarecycline being the only narrow-spectrum antibiotic approved for acne.
One of the most common ways dermatologists currently seek to reduce the potential for drug resistance is to use combination therapy. This could take many forms: for mild to moderate acne, it could mean a combination of topical agents (topical antibiotics combined with benzoyl peroxide and/or retinoids).
Sources: Dermatology Times
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