Antibiotic Resistance Considerations of Importance to Clinical Dermatologists

Abstract

The topic of antibiotic resistance has gained progressive attention globally in the lay press, in the medical literature, and among several organizations who are actively promoting antibiotic stewardship in the United States (US) and many other countries. 1-10 In fact, many countries, such as in Europe, have preceded the US in strongly promoting initiatives to limit antibiotic prescribing over the past few decades due to concerns related to the consequences of widespread antibiotic resistance and the slow development of new antibiotics. 1-3,8,9 In the US and within the specialty of dermatology, The Scientific Panel on Antibiotic Use in Dermatology (SPAUD), a project administered by the American Acne & Rosacea Society (AARS), has been evaluating antibiotic use within the dermatology specialty since 2005 and has provided educational initiatives and publications related to the subject of bacterial resistance to antibiotics and optimal antibiotic prescribing. 2,3,11-15 Several leading dermatologists with strong clinical and academic interest in ABSTRACT Antibiotic resistance is a major health concern worldwide as the list of bacterial pathogens that are insensitive to available antibiotics continues to grow in both hospitals and outpatient communities. The slow development of newer antibiotics adds to the formidable challenge that clinicians face with treatment of infections caused by antibiotic-resistant bacteria. This article discusses important caveats related to antibiotic use in dermatology. These include understanding that both topical and oral antibiotics contribute to the emergence and spread of resistant bacteria, that antibiotic monotherapy is to be avoided for treatment of acne vulgaris, that effective treatment of rosacea does not require the use of an antibiotic, that antibiotic therapy in the management of atopic dermatitis is best limited to treatment of an active clinical infection, and that routine post-operative use of a topical antibiotic is not suggested after most office-based dermatologic procedures. By following principles of antibiotic stewardship, dermatologists are major players in the battle against antibiotic resistance.