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American Journal of Clinical Dermatology
Published in: American Journal of Clinical Dermatology 6/2020

01-12-2020 | Probiotics | Review Article

Antibiotic Resistance in Acne: Mechanisms, Complications and Management

Authors: Melek Aslan Kayiran, Ayse Serap Karadag, Safaa Al-Khuzaei, WenChieh Chen, Lawrence Charles Parish

Published in: American Journal of Clinical Dermatology | Issue 6/2020

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Abstract

Antibiotic resistance in acne was first observed in the 1970s, and since the 1980s has become a major concern in dermatologic daily practice. The mechanisms for this type of resistance include biofilm formation that promotes virulence and the transmission of resistant bacterial strains. Genetic mutations with modification of ribosomal RNA, alteration in efflux pumps, and enzymatic inactivation are able to create resistance to tetracyclines and macrolides. The state of art in acne treatment is no longer to use antimicrobials as monotherapy. There should be a time limit for its use plus the employment of non-antibiotic maintenance. Earlier initiation of oral isotretinoin therapy should be considered in patients with insufficient response to antimicrobials, severe acne, or a history of repeated antimicrobial use. A better understanding of acne pathogenesis, the subtypes of Propionibacterium (also known as Cutibacterium) acnes, homeostasis of the skin microbiota, and the mechanisms of antibiotic resistance would be useful in the selection of narrow-spectrum or species-specific antimicrobials, as well as the non-antimicrobial, anti-inflammatory treatment of acne. A number of novel treatments awaiting clinical proof may include the use of bacteriophages, natural or synthetic antimicrobial peptides, probiotics, and biofilm-targeting agents, as well as the reassessment of phototherapy.
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Metadata
Title
Antibiotic Resistance in Acne: Mechanisms, Complications and Management
Authors
Melek Aslan Kayiran
Ayse Serap Karadag
Safaa Al-Khuzaei
WenChieh Chen
Lawrence Charles Parish
Publication date
01-12-2020
Publisher
Springer International Publishing
Published in
American Journal of Clinical Dermatology / Issue 6/2020
Print ISSN: 1175-0561
Electronic ISSN: 1179-1888
DOI
https://doi.org/10.1007/s40257-020-00556-6

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