Effect of Antibiotics on the Oropharyngeal Flora in Patients With Acne

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Abstract
INDIVIDUALS WITH acne are generally healthy patients often exposed to antibiotics for prolonged periods. They are, therefore, a natural population of patients in whom to study the effects of long-term antibiotic use. It is believed that appropriate but long-term use of antibiotics by patients and physicians has played a role in the development of organisms that are now resistant to multiple antibiotics.1,2 Importantly, these changes are not always permanent. For example, reductions in the use of antibiotics have been shown to result in subsequent decreases in bacterial resistance in Streptococcus pyogenes.2,3 Tetracyclines and erythromycin are 2 antibiotics commonly used in dermatological practice for the long-term treatment of acne vulgaris.1 Studies have shown that Propionibacterium acnes and coagulase-negative staphylococci quickly develop resistance to these antibiotics,4,5 which may result in therapeutic failure and the propagation of resistance to bacteria in the skin6 and gastrointestinal flora of close contacts.7 While the effects of long-term antibiotic use on cutaneous microbial environments in this patient population have been well studied, the effects on noncutaneous surfaces such as the oropharynx (which could be a source of systemic illness) have not.