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Systematic review of Propionibacterium acnes resistance to systemic antibiotics.
Med J Aust 1998; 169(5):259-61MJ

Abstract

OBJECTIVE

To document changes in the prevalence of resistance of Propionibacterium acnes to antibiotics used for treating acne.

DATA SOURCES

MEDLINE and EMBASE were searched for publications on P. acnes resistance to systemic antibiotics. The search strategy mapped "acne" or "acne vulgaris" with the terms "antibiotic resistance" or "drug resistance, microbial". Only papers published in English during 1976 to 1997 were included in the search.

STUDY SELECTION

53 publications met the search criteria. The search output was refined by selecting papers that specifically addressed P. acnes resistance patterns. Additional studies (not included in the search output) were identified from review articles and references of the retrieved articles. Twelve articles were reviewed.

DATA EXTRACTION

Data on the prevalence of antibiotic-resistant propionibacteria, the incidence of individual resistance phenotypes, mixed resistance, and correlation between poor therapeutic response and resistant propionibacteria were extracted.

DATA SYNTHESIS

Research since 1978 has suggested an association between poor therapeutic response and antibiotic-resistant propionibacteria. The overall incidence of P. acnes antibiotic resistance has increased from 20% in 1978 to 62% in 1996. Resistance to specific antibiotics varied and was most commonly reported with erythromycin and clindamycin, tetracycline and doxcycline, and trimethoprim. Resistance to minocycline is rare.

CONCLUSIONS

In many patients with acne, continued treatment with antibiotics can be inappropriate or ineffective. It is important to recognise therapeutic failure and alter treatment accordingly. The use of long-term rotational antibiotics is outdated and will only exacerbate antibiotic resistance.

Authors+Show Affiliations

Department of Dermatology, Royal North Shore Hospital, St Leonards, NSW.

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

9762064

Citation

Cooper, A J.. "Systematic Review of Propionibacterium Acnes Resistance to Systemic Antibiotics." The Medical Journal of Australia, vol. 169, no. 5, 1998, pp. 259-61.
Cooper AJ. Systematic review of Propionibacterium acnes resistance to systemic antibiotics. Med J Aust. 1998;169(5):259-61.
Cooper, A. J. (1998). Systematic review of Propionibacterium acnes resistance to systemic antibiotics. The Medical Journal of Australia, 169(5), pp. 259-61.
Cooper AJ. Systematic Review of Propionibacterium Acnes Resistance to Systemic Antibiotics. Med J Aust. 1998 Sep 7;169(5):259-61. PubMed PMID: 9762064.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Systematic review of Propionibacterium acnes resistance to systemic antibiotics. A1 - Cooper,A J, PY - 1998/10/8/pubmed PY - 1998/10/8/medline PY - 1998/10/8/entrez SP - 259 EP - 61 JF - The Medical journal of Australia JO - Med. J. Aust. VL - 169 IS - 5 N2 - OBJECTIVE: To document changes in the prevalence of resistance of Propionibacterium acnes to antibiotics used for treating acne. DATA SOURCES: MEDLINE and EMBASE were searched for publications on P. acnes resistance to systemic antibiotics. The search strategy mapped "acne" or "acne vulgaris" with the terms "antibiotic resistance" or "drug resistance, microbial". Only papers published in English during 1976 to 1997 were included in the search. STUDY SELECTION: 53 publications met the search criteria. The search output was refined by selecting papers that specifically addressed P. acnes resistance patterns. Additional studies (not included in the search output) were identified from review articles and references of the retrieved articles. Twelve articles were reviewed. DATA EXTRACTION: Data on the prevalence of antibiotic-resistant propionibacteria, the incidence of individual resistance phenotypes, mixed resistance, and correlation between poor therapeutic response and resistant propionibacteria were extracted. DATA SYNTHESIS: Research since 1978 has suggested an association between poor therapeutic response and antibiotic-resistant propionibacteria. The overall incidence of P. acnes antibiotic resistance has increased from 20% in 1978 to 62% in 1996. Resistance to specific antibiotics varied and was most commonly reported with erythromycin and clindamycin, tetracycline and doxcycline, and trimethoprim. Resistance to minocycline is rare. CONCLUSIONS: In many patients with acne, continued treatment with antibiotics can be inappropriate or ineffective. It is important to recognise therapeutic failure and alter treatment accordingly. The use of long-term rotational antibiotics is outdated and will only exacerbate antibiotic resistance. SN - 0025-729X UR - https://www.unboundmedicine.com/medline/citation/9762064/abstract/Systematic_review_of_Propionibacterium_acnes_resistance_to_systemic_antibiotics L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0025-729X&date=1998&volume=169&issue=5&spage=259 DB - PRIME DP - Unbound Medicine ER -