Daijiworld Media Network - Shanghai

Shanghai, Mar 27: A real-world retrospective study from Shanghai has found that prolonged use of oral antibiotics for moderate-to-severe Acne may do more harm than good, increasing recurrence rates and antimicrobial resistance without improving short-term outcomes.

Researchers analysed data from 240 patients aged 12 to 40 years who were treated with Doxycycline or Minocycline between 2020 and 2023. Patients were divided into three groups based on treatment duration — short-term (6–12 weeks), standard-term (13–16 weeks), and prolonged therapy (17–24 weeks), with 80 individuals in each group.

The study found a clear increase in acne recurrence with longer treatment duration. Recurrence rates stood at 23.8% in the short-term group, rising to 35.0% in the standard group and 46.3% among those on prolonged therapy. Median recurrence-free survival also declined from 9.2 months in the short-term group to 6.9 months in the prolonged group. Statistical analysis identified extended antibiotic use as an independent predictor of relapse.

Despite this, short-term outcomes remained similar across all groups. Around 75% of patients in each category achieved treatment success at 12 weeks, with no significant differences in scarring or adverse events, indicating no added benefit from extended antibiotic use.

However, antimicrobial resistance was notably higher with prolonged therapy. In a subset of patients who underwent microbial testing, resistance to tetracycline antibiotics was significantly higher at 42.9% in the prolonged group, compared to 13.3–17.6% in the short- and standard-term groups.

The findings underline concerns over excessive use of systemic antibiotics in acne treatment. Experts noted that longer courses do not improve outcomes but instead increase the risk of relapse and drug resistance.

The study recommends limiting antibiotic duration and emphasises the need for antimicrobial stewardship in acne management, in line with existing clinical guidelines.