Antibiotics and acne: an emerging iceberg of antibiotic resistance?

Extract

In the entire history of medicine, few therapeutic options have been as successful in curing disease as antibiotics. However, the future effectiveness of antibiotics is now in jeopardy, with the World Health Organization declaring the threat of antibiotic resistance (AR) a most urgent crisis.1 Similarly, in the U.K., the Chief Medical Officer (CMO) has warned of the apocalyptic nature of AR and more recently has suggested that gains achieved in mortality reductions during the last century could be offset by increases in AR‐related mortality.2

Acne vulgaris is an important disease to focus on in relation to AR as more than 80% of adolescents and young adults have acne, and prolonged broad‐spectrum oral antibiotic treatment is the standard of care for moderate‐to‐severe acne.3,4 While clinical experience strongly favours the use of oral antibiotics to treat acne, there is a dearth of data exploring the association between AR and long‐term antibiotic use in acne.5