Long-term oral antibiotic use in people with acne vulgaris in UK primary care: a drug utilization study.
Br J Dermatol
; 188(3): 361-371, 2023 02 22.
Article
en En
| MEDLINE
| ID: mdl-36670540
ABSTRACT
BACKGROUND:
The inappropriate use of antibiotics is understood to contribute to antimicrobial resistance. Oral antibiotics are regularly used to treat moderate-to-severe acne vulgaris. In practice, we do not know the typical length of oral antibiotic treatment courses for acne in routine primary care and what proportion of people receive more than one course of treatment following a new acne diagnosis.OBJECTIVES:
To describe how oral antibiotics are prescribed for acne over time in UK primary care.METHODS:
We conducted a descriptive longitudinal drug utilization study using routinely collected primary care data from the Clinical Practice Research Datalink GOLD (2004-2019). We included individuals (8-50â years) with a new acne diagnosis recorded between 1 January 2004 and 31 July 2019.RESULTS:
We identified 217 410 people with a new acne diagnosis. The median age was 17â years [interquartile range (IQR) 15-25] and median follow-up was 4.3â years (IQR 1.9-7.6). Among people with a new acne diagnosis, 96 703 (44.5%) received 248 560 prescriptions for long-term oral antibiotics during a median follow-up of 5.3â years (IQR 2.8-8.5). The median number of continuous courses of antibiotic therapy (≥ 28â days) per person was four (IQR 2-6). The majority (n = 59 010, 61.0%) of first oral antibiotic prescriptions in those with a recorded acne diagnosis were between the ages of 12 and 18. Most (n = 71 544, 74.0%) first courses for oral antibiotics were for between 28 and 90â days. The median duration of the first course of treatment was 56â days (IQR 50-93â days) and 18 127 (18.7%) of prescriptions of ≥ 28â days were for < 6 weeks. Among people who received a first course of oral antibiotic for ≥ 28â days, 56 261 (58.2%) received a second course after a treatment gap of ≥ 28â days. The median time between first and second courses was 135â days (IQR 67-302). The cumulative duration of exposure to oral antibiotics during follow-up was 255â days (8.5â months).CONCLUSIONS:
Further work is needed to understand the consequences of using antibiotics for shorter periods than recommended. Suboptimal treatment duration may result in reduced clinical effectiveness or repeated exposures, potentially contributing to antimicrobial resistance.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Acné Vulgar
Límite:
Adolescent
/
Adult
/
Child
/
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Br J Dermatol
Año:
2023
Tipo del documento:
Article
País de afiliación:
Reino Unido