Tetracyclines, macrolides, and trimethoprim/sulfamethoxazole are effective and safe in the treatment of moderate-to-severe inflammatory acne, according to recent evidenced-based review. A systematic literature review was conducted to identify randomized controlled clinical trials, systematic reviews, and meta-analyses evaluating the efficacy of oral antibiotics for acne. Overall, 41 articles that examined oral antibiotics compared with placebo, another oral therapy, topical therapy, alternate dose, or duration were included in this study. Researchers found:
- Superior efficacy of one type or class of antibiotic could not be determined. Therefore, the choice of antibiotic is generally based on the side-effect profile.
- The combination of oral antibiotics with a topical therapy is superior to oral antibiotics alone.
- Due to increasing resistance to antibiotics, dermatologists should heed consensus guidelines for their appropriate use.
Bienenfeld A, Nagler AR, Orlow SJ. Oral antibacterial therapy for acne vulgaris: An evidence-based review. Am J Clin Dermatol. 2017;18(4):469-490. doi:10.1007/s40257-017-0267-z.
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