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| Topical Antibiotics |  Antibiotics have an effect on Propionibacterium acne, the bacteria linked, in part, with the inflammation of acne. Theoretically, if the bacteria is reduced in numbers then less inflammation can take place and less acne occur.
The antibiotics that are used as topical treatments in mild to moderate acne listed alphabetically are:
• Topical clindamycin.
• Topical erythromycin.
• Topical tetracycline.
How Effective are These Topical Antibiotics?
Acne treatment with a combination of zinc and antibiotic is more effective than using antibiotic alone and such effective as treatment with oral antibiotics. Antibiotics also may be combined with benzoyl peroxide to make better effect.
It is necessary to use the topical treatments correctly, in particular the prescribed number of times per day. Benefit will not appear at once and will develop over a number of weeks.
Can the Bacteria Become Resistant?
The appearance of strains of Propionibacterium acnes and Staphylococcus epidermidis that are firm to antibiotics is an increasing problem. The researches have shown that 25% of acne patients were found to have erythromycin resistant strains regardless of previous exposure to erythromycin.
This resistance is significant, as carriers of erythromycin resistant propionibacterium do not respond to oral erythromycin. There is also cross resistance between clindamycin and erythromycin emerging. However, there is some evidence that erythromycin resistance may be overcome or prevented by using benzoyl peroxide, or zinc acetate in the same treatment, or by increasing the concentration of the erythromycin to 4%. Zinc acetate has anti- bacterial activity itself. It is preferable to prescribe non- antibiotic antimicrobials, such as benzoyl peroxide or a combination of a topical antibiotic with a non- antibiotic antimicrobial, rather than a single antibiotic preparation on its own.
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