Tetracycline Hydrochloride in the Treatment of Acne Vulgaris

Acne and antibiotics: a look back

“…Numerous subsequent studies consistently found that long‐term treatment with tetracycline brought about significant improvement, leading to the broadening of its use 19,20 . Tetracyclines were ultimately determined to have superior clinical efficacy compared with alternative available drugs, with erythromycin placing in the runner‐up spot 21–23 .…”

“…Sometimes a small decrease in concentration of the microorganism would be met with dramatic clinical improvement; just as often, its eradication would not produce visible change 34 . Moreover, low antibiotic doses seemingly insufficient for an antimicrobial effect were nevertheless found to offer some relief 19 . It was therefore apparent that acne was not a purely infectious process, and other probable factors such as sebum overproduction and inflammation were likely also at play.…”

Acne Pathogenesis: History of Concepts

“…In the following years, additional works reinforced the credit of antibiotics and therefore emphasized the role of microorganisms even though their exact roles remained unknown. Cronck et al [220], using tetracycline in over 70 patients, observed a reduction of the pustules in more than 60 patients within 2 months. King and Forbes [221] obtained similar results.…”

Susceptibility to Infections during Long-Term Treatment with Tetracyclines in Acne vulgaris

“…Of 72 cases, virus infections occurred in 19. They were not materially affected, either adversely or beneficially, by the tetracycline therapy [1], No boils or other infections with antibiotic-resistant staphylococci were observed by G o l t z and K ja rtansson [4], Of 208 patients, none developed a major systemic illness. The authors were not able to determine whether these patients had a lower or higher incidence of bacterial infections, such as streptococcal throat infec tions or otitis media [5].…”

“…During courses of systemic broad-spectrum antibiotics, given over long periods, folliculitis of the face occurred. The organism responsible was a gram-negative bacterium, normally of low pathogenicity [3], Moniliasis was not observed in any of 238 patients with acne who were on tetracycline [2]; but in another group of 208 acnepatients, vaginitis due to Candida albicans was the only severe complication which required therapy [5], In a further series of 72 cases, the problem of the development or the potentiation of Candida albicans infections was of considerable importance [1],…”