Acne Vulgaris — SCE Dermatology MCQ

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EasyInflammatory DermatosesAcne VulgarisSCE Dermatology

A 25-year-old man with moderate acne has been prescribed Lymecycline 408 mg daily for 4 months. His acne has improved but he wants to continue the antibiotic. According to BAD guidelines, what is the maximum recommended duration for oral antibiotics in acne?

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Correct answer: A — 6 months maximum — prolonged courses promote antibiotic resistance

BAD and NICE guidelines recommend that oral antibiotics for acne should not be continued beyond 6 months (maximum) due to antimicrobial resistance concerns. If the acne has not adequately responded by 3-4 months, the antibiotic should be changed or treatment escalated (to Isotretinoin for severe/scarring acne). If good response at 3 months, the antibiotic can be continued to 6 months maximum then stopped, with maintenance using topical retinoid + benzoyl peroxide. Repeated or prolonged antibiotic courses should be avoided. Topical antibiotics should never be used as monotherapy and should always be combined with BPO to prevent resistance. The combination of oral + topical antibiotic is specifically not recommended.

Reference: BAD 2023 Acne Guidelines; NICE CKS