Effect of Antibiotics on the Oropharyngeal Flora in Patients With Acne

Antibiotic Treatment of Acne May Be Associated With Upper Respiratory Tract Infections

“…While the effects of longterm antibiotic use on cutaneous microbial environments in patients with acne have been well studied, the effects of this therapy on noncutaneous surfaces, such as the oropharynx, which could be a source of systemic illness, have not. [3][4][5][6][7][8][9] Upper respiratory tract infections (URTIs), such as pharyngitis, are extraordinarily common acute medical problems, primarily of viral origin. In general, about 10% of URTIs are likely due to a bacterial source.…”

“…[10][11][12][13] However, we recently demonstrated that nearly 35% of the patients with acne who were receiving antibiotic therapy and who had no URTI symptoms had group A streptococci in their CME course available at www.archdermatol.com For editorial comment see page 1157 upper airway and that nearly 85% of these strains were resistant to tetracyclines. 4 While the vast majority of URTIs are not of bacterial origin, recent studies have shown that infections may be polymicriobial, in that one organism facilitates the infectious capability of another.…”

“…15,16 We recently demonstrated that antibiotic therapy for acne, when given topically and/or orally to young adults, may profoundly affect an individual's likelihood of being colonized with group A streptococci, an organism associated with a common acute medical illness: pharyngitis. 4 Our goal was to determine whether the long-term use of antibiotics for acne results in an increase in a common infectious illness: URTI. To that end, we conducted a retrospective cohort study using the General Practice Research Database (GPRD).…”

Acne Vulgaris

“…Potential issues of concern that have been raised in this manner include increased prevalence of P. acnes strains less responsive to antibiotics, alterations in cutaneous flora, decreased therapeutic responsiveness to antibiotic therapy, and promotion of other clinical infections among treated patients and/or their close contacts. Apart from these, pharyngeal colonization with Streptococcus pyogenes and a possible increased risk of an upper respiratory tract infection have been associated with chronic use of antibiotics for acne, including topical agents [76,77].…”

Community Factors in the Development of Antibiotic Resistance

“…In the past decade, antibiotic resistance has been increasingly identified in the community. Although community factors are also important in the spread of resistance (11,38,46,49), less attention has been focused on nonhealth care settings. Antimicrobial resistance is not limited to bacteria; resistance to antiviral agents against the human immunodeficiency virus (HIV), for example, has rapidly emerged, as has chloroquine resistance against the parasite that causes malaria.…”