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Antibiotic therapy for hidradenitis suppurativa may induce antibiotic resistance

Certain antibiotic therapy may be inducing antibiotic resistance in patients with hidradenitis suppurativa, according to study results recently published in the Journal of the American Academy of Dermatology.

Researchers conducted a cross-sectional analysis of 239 patients diagnosed with hidradenitis suppurativa (HS) who were seen between 2010 and 2015 at the Johns Hopkins Medical Institutions. The patients had bacterial culture data from HS lesions.

There were 227 patients with information on antibiotic use at the time of bacterial culture, with 122 (54%; mean age, 39.2 years) having documented antibiotic use and 105 (mean age, 39.5 years) having no documented antibiotic use.

Sixty-three percent of patients using topical clindamycin grew clindamycin-resistant Staphylococcus aureus vs. 17% of patients not on antibiotics (P = .03). All patients taking ciprofloxacin were likely to grow ciprofloxacin-resistant methicillin-resistant S. aureus compared with 10% of patients not on antibiotics (P = .045).

Patients who received trimethoprim/sulfamethoxazole had an 88% likelihood to grow trimethoprim/sulfamethoxazole-resistant Proteus species, compared with patients who were not on antibiotics, who had a 0% likelihood (P < .001).

Use of tetracyclines or oral clindamycin resulted in no significant antimicrobial resistance patterns.

“The findings of this study, suggesting that antibiotic use in patients with HS may be inducing antimicrobial resistance in these patients, highlight the importance of antibiotic stewardship in HS treatment and raise questions regarding whether the use of antibiotics in patients with HS experiencing limited effectiveness from this therapy justifies the potential harms associated with emerging antibiotic resistance,” the researchers concluded. – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.