Oral Antibiotic Therapy for Acne

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The use of oral antibiotics can be used as a next step from topical agents such as benzoyl peroxide and retinoid creams, gels and lotions. Antibiotic therapy is good for inflammatory acne and has been shown to be very effective in some patients.

In the clinical world, oral antibiotic acne therapy is usually referred to as systemic antibacterial treatment. The word systemic implies that the antibiotics travel around the blood stream; not only to the websites where there is acne, but to websites where acne is not present.

Broadly speaking, oral antibiotic acne drugs can be divided into 3 maily names:
1.Cyclines
2.Macrolides
3.Sulphonamides

The Cyclines
Either oxytetracycline or tetracycline is given for acne in a dose of 500mg twie daily. If there is no improvement afterwards the first 3 months, another oral antibacterial should be used.

Usually, maximum improvement can be seen 4 to 6 months afterwards treatment but in some cases treatment must be carried on for 2 years or even longer.

Doxycyline and minocycline are alternatives to the above named tetracyclines. Doxycycline may be used in a dose of 100mg daily. Minocycline offers less likelihood of bacterial resistance but may sometimes cause irreversible pigmentation. I can be given in a dose of 100mg daily (i.e. in two 50mg tablets or just one tablet of 100mg).

The Macrolides
In this case one subcategoray of macrolide is used. This drug is commonly known as erythromycin. This can be given in doses of 500mg twice daily. Although this is an alternative for the management of acne, in some cases, the bacteria propionibacteria has become resistant to erythromycin.

The Sulphonamides
The drug trimethoprim is classed as the best drug out of the sulphonamides to target acne. It can be given in doses of 300mg twice daily and may be used for acne resistant to other antibacterials. Prolonged treatment with trimethoprim may depress the bone marrow function (although this is rare) of the body; this drug should only be prescribed by consultant dermatologists. Regular bone marrow and full blood count tests should be performed when this drug is used for an extended period of time.

Common side effects of antibiotics used for acne management:

Cyclines:
1.Nausea
2.Vomiting
3.Diarrhoea

Macrolides (Erythromycin):
1.Nausea
2.Vomiting
3.Abdominal discomfort
4.Rashes
5.Reversible hearing loss

Sulphonamides (Trimethoprim)
1.Gastro-intestinal disturbances
2.Nausea
3.Vomiting
4.Itchiness and rashes

Antibiotics serve as another form of therapy for treating acne but, in order to achive positive results, one must stick to the treatment regimens and try to complete the prescribed course.

Please note that the above editorial by no means serves as complete literature regarding the topic of interest. For more detailed information, please consult your local physician.

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