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Drug-resistant Bacteria Shifting the Treatment of Acne

Posted: April 17, 2009

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He has a appointment with his doctor next week to figure out what went wrong, but from his own medical Googling and time spent on message boards such as acne.org, he expects he’s developed this antibiotic resistance. But maybe the strangest thing about this particular affliction is that patients never really know for sure that they have it at all. “Most people in private practice do not do a test,” says Keri, the Miami dermatologist. “If they thought [patients] were resistant, they might switch antibiotics or add topical treatment to the mix.”

The P. acnes bacterium can be tested for resistance, but that’s usually done only in clinical trials or study circumstances. When a patient stops responding to antibiotics, most dermatologists assume the bacteria have developed resistance, and doctors simply try something else.

A bevy of effective treatments

Bacteria, resistant or not, is only one contributer to the formation of a zit. Four things have to happen for people to get a pimple: First, oil increases in a pore. Second, the skin cells that line the pore get sticky from the extra oil, creating a clog in that pore. Third, bacteria feasts on all that oil and begin to overgrow. Finally, the body responds to the bacteria, causing the inflammation.

“The fact is, because acne is much more complicated than a simple infection, there really are a wide variety of other approaches that are very useful,” says Fleischer of Wake Forest University. Doctors found that combining benzoyl peroxide with an antibiotic counteracts the drug resistance. And there are plenty of other methods dermatologists use to attack acne, including using anti-inflammatory drugs such as retinoids and isotretinoin.