Severe acne treatment is delayed by ineffective antibiotics

A study of records at New York University's Langone Medical Center determined that too many patients being treated for severe acne are being left on ineffective antibiotics for too long before being prescribed isotretinoin (also known by its former brand name Accutane).

"Our study suggests that physicians need to recognize within weeks, not months, when patients are failing to respond to antibiotic therapy in cases of severe acne," senior investigator Seth Orlow, the Samuel Weinberg Professor of pediatric dermatology, said.
  
The medical files show that, on average, patients with severe acne were kept on ineffective medicine for 11 months before being switched to isotretinoin therapy. After being prescribed to isotretinoin, there was a six-month wait before the patients saw a change in their acne.

"Physicians and patients have become far too complacent about antibiotic overuse and its subsequent danger of increasing microbial drug resistance," Orlow said.

The 137 medical records were of patients 12 and older who sought treatment between 2005 and 2014. 

"Acne remains the number one reason for young people to visit a dermatologist, and there are no other medications as effective as isotretinoin for treating severe cases of the skin condition," dermatologist Arielle Nagler, the lead study investigator, said. "We need to find a better balance between trying antibiotics that may work and getting isotretinoin quickly to patients for whom antibiotics are not working. Physicians also need to start talking to their acne patients earlier about possible isotretinoin therapy, so when and if they do need to switch to it, patients are more receptive to the drug and any concerns about side effects have already begun to be addressed.”

The study findings were published online Friday in the Journal of the American Academy of Dermatology.