Is there an association between long-term antibiotics for acne and subsequent infection sequelae and antimicrobial resistance? A systematic review.
acne vulgaris
antibiotic
antimicrobial resistance
dihydrofolate reductase inhibitor
macrolides
tetracycline
Journal
BJGP open
ISSN: 2398-3795
Titre abrégé: BJGP Open
Pays: England
ID NLM: 101713531
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
07
12
2020
accepted:
19
01
2021
pubmed:
11
3
2021
medline:
11
3
2021
entrez:
10
3
2021
Statut:
epublish
Résumé
Antimicrobial resistance (AMR) is a global health priority. Acne vulgaris is a common skin condition for which antibiotic use ranges from a few months to years of daily exposure. To systemically search for and synthesise evidence on the risk of treatment-resistant infections, and other evidence of AMR, following long-term oral antibiotic use for acne. In this systematic review, a literature search was carried out using the databases Embase, MEDLINE, Cochrane, and Web of Science. They were searched using MeSH, Emtree, or other relevant terms, and followed a pre-registered protocol. Search strategies were developed with a librarian and undertaken in July 2019. All searches date from database inception. The primary outcome was antibiotic treatment failure or infection caused by a resistant organism. Secondary outcomes included detection of resistant organisms without an infection, rate of infection, or changes to flora. A total of 6996 records were identified. Seventy-three full-text articles were shortlisted for full review, of which five were included. Two investigated rates of infection, and three resistance or changes to microbial flora. Three studies had 35 or fewer participants (range 20-118 496). Three studies had a serious or high risk of bias, one moderate, and one a low risk of bias. Weak evidence was found for an association between antibiotic use for acne and subsequent increased rates of upper respiratory tract infections and pharyngitis. There is a lack of high quality evidence on the relationship between oral antibiotics for acne treatment and subsequent AMR sequelae. This needs to be urgently addressed with rigorously conducted studies.
Sections du résumé
BACKGROUND
BACKGROUND
Antimicrobial resistance (AMR) is a global health priority. Acne vulgaris is a common skin condition for which antibiotic use ranges from a few months to years of daily exposure.
AIM
OBJECTIVE
To systemically search for and synthesise evidence on the risk of treatment-resistant infections, and other evidence of AMR, following long-term oral antibiotic use for acne.
DESIGN & SETTING
METHODS
In this systematic review, a literature search was carried out using the databases Embase, MEDLINE, Cochrane, and Web of Science. They were searched using MeSH, Emtree, or other relevant terms, and followed a pre-registered protocol.
METHOD
METHODS
Search strategies were developed with a librarian and undertaken in July 2019. All searches date from database inception. The primary outcome was antibiotic treatment failure or infection caused by a resistant organism. Secondary outcomes included detection of resistant organisms without an infection, rate of infection, or changes to flora.
RESULTS
RESULTS
A total of 6996 records were identified. Seventy-three full-text articles were shortlisted for full review, of which five were included. Two investigated rates of infection, and three resistance or changes to microbial flora. Three studies had 35 or fewer participants (range 20-118 496). Three studies had a serious or high risk of bias, one moderate, and one a low risk of bias. Weak evidence was found for an association between antibiotic use for acne and subsequent increased rates of upper respiratory tract infections and pharyngitis.
CONCLUSION
CONCLUSIONS
There is a lack of high quality evidence on the relationship between oral antibiotics for acne treatment and subsequent AMR sequelae. This needs to be urgently addressed with rigorously conducted studies.
Identifiants
pubmed: 33687983
pii: BJGPO.2020.0181
doi: 10.3399/BJGPO.2020.0181
pmc: PMC8278499
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : Wellcome Trust
ID : 205039/Z/16/Z
Pays : United Kingdom
Organisme : Department of Health
ID : DRF-2018-11-ST2-066
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/T032448/1
Pays : United Kingdom
Informations de copyright
Copyright © 2021, The Authors.
Références
J Am Acad Dermatol. 2014 Jul;71(1):70-6
pubmed: 24725476
J Am Acad Dermatol. 2016 Dec;75(6):1142-1150.e1
pubmed: 27502311
J Antimicrob Chemother. 2007 Feb;59(2):292-6
pubmed: 17110392
Br J Dermatol. 2013 Mar;168(3):474-85
pubmed: 23210645
Arch Dermatol. 2005 Sep;141(9):1132-6
pubmed: 16172310
Br Med J. 1975 Oct 11;4(5988):71-4
pubmed: 1102059
J Invest Dermatol. 1985 Jul;85(1):35-7
pubmed: 3159802
Br J Dermatol. 1976 Sep;95(3):311-6
pubmed: 135573
J Am Acad Dermatol. 2016 May;74(5):945-73.e33
pubmed: 26897386
Arch Dermatol. 2012 Mar;148(3):326-32
pubmed: 22105812
J Eur Acad Dermatol Venereol. 2016 Aug;30(8):1261-8
pubmed: 27514932
Antimicrob Agents Chemother. 1996 Nov;40(11):2598-604
pubmed: 8913472
Br J Dermatol. 2016 Dec;175(6):1127-1128
pubmed: 27996153
Am J Clin Dermatol. 2017 Aug;18(4):469-490
pubmed: 28255924
J Invest Dermatol. 1979 Apr;72(4):187-90
pubmed: 429800
BMJ Open. 2020 Jul 2;10(7):e033662
pubmed: 32616485
BMJ. 2015 Jan 02;350:g7647
pubmed: 25555855
Lancet Infect Dis. 2015 Dec;15(12):1438-49
pubmed: 26411518
J Am Acad Dermatol. 1983 Jan;8(1):41-5
pubmed: 6219134
J Eur Acad Dermatol Venereol. 2013 Mar;27(3):332-6
pubmed: 22239608
Br J Dermatol. 2003 Mar;148(3):467-78
pubmed: 12653738
BMJ. 2016 Oct 12;355:i4919
pubmed: 27733354
Br J Dermatol. 2018 Jan;178(1):76-85
pubmed: 28542914
BMJ. 2011 Oct 18;343:d5928
pubmed: 22008217
Arch Dermatol Res. 2010 Dec;302(10):745-56
pubmed: 20697725
Br J Dermatol. 1998 Dec;139 Suppl 53:4-8
pubmed: 9990406
Lancet. 2004 Dec 18-31;364(9452):2188-95
pubmed: 15610805
Scand J Infect Dis Suppl. 1984;43:76-81
pubmed: 6242074