What is your opinion on antibiotic use for acne?

Nurses General Nursing

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Specializes in Acute Spine, Neuro, Thoracic's, LTC.

I am currently working and a med-spa (though I have put my notice in and am going back to hospital nursing in a week).

The Dr. at this facility frequently prescribes antibiotics for long term use for people with acne problems. I am not sure I really agree with this considering all of the superbugs out there that we are creating due to overuse of antibiotics. Just wondering what everyone else thought of this?

I currently use Clindamycin Topical gel combined with Tretinoin cream to keep my skin clear.

I have been using these two meds together for over 8 years now and havent had a problem.

This was prescribed to me by my doctor.

Specializes in Acute Spine, Neuro, Thoracic's, LTC.

I didn't mean topical antibiotics. He is prescribing people oral antibiotics such as erythromycin.

Specializes in ER/ICU/STICU.

From the research that I can find it appears that long term oral ABX are used for acne that doesn't respond to topical ones.

I agree with you that ABX are way overused and creating more superbugs all the time. It also appears that it is creating antibiotic resistant acne. That being said, there seems to be a clear medical indication for the use of the abx for the acne that hasn't responded to topicals. It's not like he is prescribing them for the sniffles.

Specializes in Utilization Management.

I'm confused...acne is caused partly by bacteria, what else should it be treated with?

I have been on tetracycline before for my acne. I think if u don't take it like u should u set yourself up for abx resistance even more. I have done a little research about it and your ance can even become resistant to the abx over time. Not sure how I feel about it. I was the bad nurse that never took the tetracycline like I should bc I was in between "well why am I taking this and paying for bc", and the whole interaction with different foods. To much work. But the acne isn't fun either. Hopefully they will find a better cure sometime. :) Interested to see what others think.

Specializes in Acute Spine, Neuro, Thoracic's, LTC.
I'm confused...acne is caused partly by bacteria what else should it be treated with?[/quote']

There are other options to treat acne...

I have worked at another clinic that used lasers for acne treatments, and also a variety of difference creams and cleansers with good success. So if an antibiotic is going to be used I think it should definitely be a last resort. He is prescribing it sometimes before trying anything else and also sometimes to people with quite mild acne.

Acne is mainly a hormonal response, hence we suffer during puberty. Maturity usually sees the end of acne, but many continue to experience symptoms throughout their lives. The only time my skin was was clear was during pregnancy... now it's clearer because of peri-menopause.

I have tried various remedies, including topical and oral antibiotics. The only med that really worked was a low dose contraceptive pill...

On the other hand, who cares... most people I know didn't even think I had skin issues. In my experience, they are mainly interested in one's personality...

There are other options to treat acne...

I have worked at another clinic that used lasers for acne treatments, and also a variety of difference creams and cleansers with good success. So if an antibiotic is going to be used I think it should definitely be a last resort. He is prescribing it sometimes before trying anything else and also sometimes to people with quite mild acne.

While I agree that antibiotics shouldn't be used in cases when there is not bacterial involvement, I think both cost and efficacy make it reasonable after topical treatments have failed. Think about how much do those lasers treatments cost (and if they were covered by insurance, which I doubt they were)? I imagine more than the $4 both erythromycin and tetracycline cost.

Specializes in PeriOperative.

I work at a plastics office, and from what I have observed, abx treatment is pretty standard. Tetra/doxy are our typical go-to-drugs.

There are many advantages to oral abx. Some people with very sensitive skin just can't tolerate retin-A, or other common topicals. Laser tx is pretty cost-prohibitive for many patients. Some patients can't tolerate birth control, accutane, chemical peels, or other means of treating acne. If the patient's insurance covers some or all of the abx tx, it's to the patient's benefit to at least try that option.

I had HORRIBLE acne that didnt really start until I was 20. It was very bad. Localized more than just diffuse across my face. It was purulent and more like cystic or something. I was still in nursing school and it was so embarrassing. The first time someone told me I needed an antibiotic I scoffed and was very upset she said it to me. It went on for three years probably. Finally it hit me one day that OMG what if it was MRSA or something in it lol. Went to fam doctor. prescribed oral bactrim and it was cleared within the first round... like 2 weeks. Haven't had a problem since and that was a couple years ago.

So yes, I wish I would have given in way sooner. I can't believe I let it go on that long, when really all I needed was that antibiotic. I think that the type and cause of the acne plays a lot into it though.

Specializes in Acute Spine, Neuro, Thoracic's, LTC.
I work at a plastics office, and from what I have observed, abx treatment is pretty standard. Tetra/doxy are our typical go-to-drugs.

There are many advantages to oral abx. Some people with very sensitive skin just can't tolerate retin-A, or other common topicals. Laser tx is pretty cost-prohibitive for many patients. Some patients can't tolerate birth control, accutane, chemical peels, or other means of treating acne. If the patient's insurance covers some or all of the abx tx, it's to the patient's benefit to at least try that option.

All good points and reasons that I assume are why he sometimes chooses to prescribe oral antibiotics.

However what I was getting at is do you all think it is responsible to be so frequently prescribing antibiotics longterm to people for something cosmetic like acne? Couldn't this make them resistant to the antibiotic and then later in life, should they develop an infection and require antibiotics they might run into problems?

The infection control nurse at the last hospital I worked at used to question Docs about every antibiotic they prescribed because of the dangers of antibiotic resistance. Should antibiotics really be used for something cosmetic like acne?

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