Curbing the duration of antibiotic prescriptions and prescribing antibiotics in combination with therapies such as benzoyl peroxide or topical retinoids are strategies that dermatologists can implement to respond to the challenge of antibiotic resistance.
Speaking here at a workshop on translating evidence into practical guidelines in acne treatment at the annual meeting of the American Academy of Dermatology (AAD), Jonette Keri, M.D., Ph.D., Associate Professor, University of Miami, Miller School of Medicine and Chief, Dermatology Service, Miami VA Hospital, explained that the Centers for Disease Control in Atlanta is promoting antibiotic stewardship for healthcare professionals because of the growing global crisis of antibiotic resistance.
"This is to ensure that the patient gets the right dose of the right antibiotic at the right time and for the right duration," Dr. Keri said in an interview with Dermatology Times.
In dermatology circles, implementing antibiotic stewardship means avoiding antibiotic monotherapy, whether topical or oral, as well as limiting the use of oral antibiotics, typically not more than three or four months, according to Dr. Keri.
"You don't want to use just one antibiotic, oral or topical," Dr. Keri says. "You want to pair the antibiotic with benzoyl peroxide or a retinoid."
Dr. Keri points to research which recommended benzoyl peroxide should be used in conjunction with topical antibiotics to steer clear of resistance.1
Not only is there no documented resistance to benzoyl peroxide, the use of benzoyl peroxide avoids the development of antibiotic-resistant P. acnes strains, Dr. Keri explains.
Dr. Keri points to Korean research which concluded that the P. acnes of patients who were exposed to antibiotics, either topical or systemic, to manage acne, demonstrated resistance, while no P. acnes in patients who were not exposed to antibiotics for acne treatment were resistant to antibiotics.2