Hormonal Antiandrogen Therapy for Acne May Help Reduce Antibiotic Use

The use of hormonal antiandrogen acne treatment (HAAT) among women with acne should be encouraged in an effort to curtail the extended duration of systemic antibiotic therapy in this population, according to the results of a 10-year retrospective study conducted at an academic medical center and published in the American Journal of Clinical Dermatology.

The investigators sought to examine HAAT prescribing habits among dermatologists and the impact of HAAT on the use of systemic antibiotics in women with acne. Patients who were receiving HAAT (combined oral contraceptives and spironolactone) for acne between January 2005 and October 2015 were evaluated. Data from a group of female patients who had never received HAAT (control arm) were also collected.

Overall, a total of 672 women received HAAT; the control group comprised 103 women. Among all systemic treatments for acne, antibiotics were used as first-line therapy in 39% of women, combined oral contraceptives in 12% of women, and spironolactone in 21% of women.

The mean duration of antibiotic use among patients who initiated HAAT for the first time at the study site was significantly longer than in those who had received HAAT prior to presentation and continued HAAT at the study site (250.4 days vs 192.0 days, respectively; P =.021). There was a significant inverse association observed between the use of HAAT and mean antibiotic duration (P =.016).

The investigators concluded that although HAAT is not generally used as a first-line systemic therapy in women with acne, it is associated with shorter cumulative antibiotic duration and can help decrease systemic antibiotic use in this group of patients. Recognizing the increased need for antibiotic stewardship, the researchers consider HAAT to be a useful alternative to systemic antibiotic therapy that is effective and well tolerated among women with inflammatory acne.

Reference

Park JH, Bienenfeld A, Orlow SJ, Nagler AR. The use of hormonal antiandrogen therapy in female patients with acne: a 10-year retrospective study [published online March 20, 2018]. Am J Clin Dermatol. doi: 10.1007/s40257-018-0349-6