Journal Article10.1111/J.1365-2133.1989.TB01399.X
Erythromycin resistant propionibacteria in antibiotic treated acne patients: association with therapeutic failure.
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TL;DR: It is suggested that the use of oral erythromycin and/or topical clindamycin encourages the development of resistant propionibacteria and that the emergence of resistant strains is associated with therapeutic failure in erystromycin‐treated patients.
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Abstract: Erythromycin resistant (EmR) propionibacteria were isolated from the skin surface of 51% of patients treated with oral erythromycin and 42% of patients treated with topical clindamycin compared with 3% of untreated control subjects (P less than 0.001). Amongst the topical clindamycin-treated patients, there was a higher incidence of EmR propionibacterial carriage in those patients who had previously been treated with oral erythromycin (64%) than in patients with no known previous exposure to erythromycin (20%; 0.01 greater than P greater than 0.001). Patients responding to oral erythromycin treatment carried EmR propionibacteria less frequently (24%) than patients who were not responding or who had relapsed (70%; P less than 0.001). These observations suggest that the use of oral erythromycin and/or topical clindamycin encourages the development of resistant propionibacteria and that the emergence of resistant strains is associated with therapeutic failure in erythromycin-treated patients. In total 63 resistant isolates were obtained from 52 subjects. There were 42 strains of Propionibacterium acnes, 16 strains of Propionibacterium granulosum and five strains of Propionibacterium avidum. The majority of isolates were inducibly or constitutively resistant to macrolide (e.g. erythromycin), lincosamide (e.g. clindamycin) and streptogramin B type antibiotics. Therefore, the isolates are phenotypically indistinguishable from the majority of EmR bacteria in which resistance is due to methylation of 23S ribosomal RNA.
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Citations
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Managing acne in the Middle East: consensus recommendations.
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TL;DR: Information about the management of acne in the Middle East is somewhat sparse; however, several studies have recently been conducted and will be discussed in this supplement.
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Treatment of Acne Vulgaris During Pregnancy and Lactation: A Narrative Review
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References
Propionibacterium acnes resistance to antibiotics in acne patients
James J. Leyden,Kenneth J. McGinley,Stephen Cavalieri,Guy F. Webster,Otto H. Mills,Albert M. Kligman +5 more
TL;DR: The minimal inhibitory concentration of Propionibacterium acnes in seventy-five acne patients receiving long-term antibiotic therapy demonstrated the emergence of resistant strains.
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Laboratory Induction and Clinical Occurrences of Combined Clindamycin and Erythromycin Resistance in Corynebacterium acnes
TL;DR: Corynebacterium acnes strains cross-resistant to clindamycin and erythromycin were observed following long-term selection or mutagenic treatment in the laboratory and it is suggested that this resistance may result from an alteration of the 50S ribosomal subunit.
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Recalcitrant acne vulgaris. Clinical, biochemical and microbiological investigation of patients not responding to antibiotic treatment.
TL;DR: For most patients with recalcitrant acne a non‐microbiological explanation must be sought for the lack of therapeutic success, and the mean sebum excretion rate of the non‐responding patients was significantly higher than that of matched untreated acne patients.
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