The acne challenge: Management in an age of bacterial resistance

Acne vulgaris - or, more simply, acne - is the most prevalent skin disease, affecting nearly 80% of persons aged 11 to 30 years at some point in their lives.¹ The condition may persist for years sometimes into middle age and later - and may result in permanent scarring and disfigurement, emotional problems, and depression. Although many treatments for acne are available, effective management has become increasingly challenging with the emergence of antibiotic- resistant strains of Propionibacterium acnes - the gram-positive anaerobe responsible for the inflammation of acne. Resistance to P. acnes is reported to have increased from "extremely rare to occasional" in the mid 1980s to 62% in referral centers in 1996.² It is now estimated that one in four patients with acne harbors strains resistant to at least one of the major antibiotics.³ "Antibiotic therapy has been a backbone in the management of acne for many decades and probably will continue to be in the future, although, with the development of less-sensitive strains, the predictability of antibiotic therapy can no longer be assumed," stated James J. Leyden, MD, who is Professor in the Department of Dermatology at the University of Pennsylvania School of Medicine in Philadelphia. To further physician understanding of the impact of bacterial resistance in the management of acne, Dr. Leyden moderated this Medical Crossfire with a panel of leaders in the fields of dermatology, pediatrics, and infectious diseases.