Strategies to Optimize Oral Antibiotic Therapy in Acne Vulgaris

Use in moderate or severe inflammatory acne vulgaris in combination with a topical regimen that includes BP.
Avoid antibiotic monotherapy when using either an oral or topical antibiotic agent for acne vulgaris.
Discontinue (or taper) within 1 to 2 mo once new inflammatory acne lesions have stopped emerging.
Incorporate a topical retinoid into the regimen early to augment overall therapeutic benefit and prepare for discontinuation of oral agent with goal of maintaining control with topical program; may also use BP-containing formulation with topical retinoid for maintenance of control of acne.
If retreatment is needed, use the same oral antibiotic that was previously effective in the past.
  • Adapted from Gollnick et al,15 Leyden,50 and Del Rosso and Kim.70