At some point in our childhood or adult lives, we have taken an antibiotic for a bacterial infection. You may have had an ear or chest infection and were given a prescription by your doctor to take for a week or so. When you got your medication filled, your pharmacist counseled you on how to take the medication. That counseling was the very first step in avoiding bacterial resistance of that antibiotic. Your pharmacist may have told you to be sure to complete the entire course of therapy even if you were feeling better after a few doses. The antibiotic job is to kill the bacteria causing the illness.
As we effectively discover antibiotics to combat bacteria, the bacteria is effectively growing smarter as well, finding clever ways to combat the medicine. Antibiotics remain one of the greatest discoveries in modern medicine and it is our responsibility to use them correctly so we don’t potentiate bacterial resistance. Bacterial resistance is the capacity of bacteria to withstand the effects of antibiotics or biocides that are intended to kill or control them. All antibiotics are not the same and each one is formulated to kill a certain class of bacteria. Therefore, only taking an antibiotic prescribed for you for the intended period of time is key. Taking an antibiotic for the appropriate infection, with the appropriate length of therapy, will not cause bacterial resistance. It is when the incorrect medication is being used against the wrong bacteria ineffectively for the incorrect duration that resistance becomes an issue.
Dermatologists are one of the main prescribers of antibiotics because they see the largest population of patients requiring antibiotics for skin infections. Acne vulgaris is an infection of Propionibacterium acnes or P. acnes, the bacteria responsible for the infected lesions seen in acne patients. In the appropriate case, a prescription for a topical or oral antibiotic is the perfect medication and will resolve the issue after an extended course of therapy. Unlike, the antibiotic therapy for an acute ear or lung infection, antibiotics for acne require a longer treatment time. It is important to see your dermatologist for follow up visits during the antibiotic therapy so they can evaluate the next step. If upon follow up, the dermatologist notices no change in the acne appearance, they may consider changing your therapy. This is important because continuing an antibiotic that is not effective may cause bacterial resistance. There are other antibiotic-free therapies that may be offered like topical Differin, tretinoin, Aczone or Tazorac, all of which do not promote resistance. In some cases, they may give a topical antibiotic like clindamycin which must be used with benzoyl peroxide to reduce resistance. Some patients see amazing results with antibiotic therapies but once they stop the medication, the acne rebounds or flares and comes back like before. In this case, the dermatologist may consider putting the patient on a course of isotretinoin therapy.
Seeking medication counseling with your pharmacist and follow up with your dermatologist are the two most important things, you as a patient must do to avoid antibiotic resistance. Remember, antibiotic therapy will not be used for long term treatment of your acne but as a great tool to get it under control. Really wonderful antibiotic therapies your dermatologist may prescribe are Doryx, Acticlate or Solodyn. Speak to your Rx Plus Pharmacists who can guide you along your acne journey and recommend adjunctive products to enhance your antibiotic regimen.