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Pharyngitis linked to oral antibiotic use for acne treatment
Margolis DJ. Arch Dermatol. 2011;doi:10.1001/archdermatol.2011.355.
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Pharyngitis was approximately 3.5 times more likely in patients taking oral antibiotics for the treatment of acne compared with those not taking oral antibiotics, according to new findings from two studies published in the Archives of Dermatology.
“Among those with acne, the long-term use of antibiotics is associated with an increased risk of upper respiratory tract infections,” David J. Margolis, MD, PhD, of the University of Pennsylvania, told Infectious Disease News.
“We are not certain as to the etiology of this risk, but it does not seem related to changes in the rate of colonization of group A streptococcus or Streptococcus salivarius.”
For the first cross-sectional study, the researchers surveyed 266 students at the university on their history of acne, treatment for acne, antibiotic use and whether they were recently evaluated for pharyngitis.
Of the 53.5% of students who had acne, 10.3% reported oral antibiotic use, and 69.7% reported an episode of pharyngitis within the previous 30 days (OR=3.53; 95% CI, 1.14-10.95) vs. only 36.2% of students with acne not taking oral antibiotics.
For the second longitudinal study, the researchers followed 600 students for 1 year. Results indicated that 52.8% of participants had acne. Of those, 6.2% reported receipt of oral antibiotics for acne, and 25.5% reported an episode of pharyngitis within the previous 30 days. Results from the follow-up period indicated that 36.3% reported an episode of pharyngitis and 7.4% reported an episode of pharyngitis associated with a health care provider visit (OR=4.34; 95% CI, 1.51-12.47), according to study results.
Overall, the researchers found no association between colonization with group A streptococcus or S. salivarius and the risk of self-reported pharyngitis.
“The broader implications of the study may center on concerns about lon-term antibiotic use and how we evaluate risks of long-term use,” Margolis said. – by Ashley DeNyse
Disclosure: This study was supported by NIH grant R01AR051185.
After reading this study, I felt overwhelmed with data that arrived at the conclusion that if a young adult is taking an oral antimicrobial (a tetracycline) for acne, he or she has three-times the chance of having a self-reported case of pharyngitis over those not being treated during the defined period of time. While specific etiologies were not known, group A strep was found not to be the cause of this increased rate of pharyngitis. The study is thought-provoking, but until the questions of ‘why’ there are more cases of pharyngitis and ‘what’ causes the pharyngitis are answered, it’s not likely to change anyone’s clinical practice. Given the way young people think about acne, it probably won’t make much difference.
- James H. Brien, DO
Infectious Disease News Editorial Board member
Disclosure: Dr. Brien reports no relevant financial disclosures.
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