Trends in Oral Antibiotic Use for Acne Treatment: A Retrospective, Population-Based Study in the United States, 2014 to 2016

Abstract

Background: Antibiotic resistance related to prolonged antibiotic use is an emerging threat to public health. Objective: To evaluate recent trends in oral antibiotic use for acne treatment. Methods: A retrospective study was conducted from January 2014 through September 2016 using the IBM MarketScan® claims database. Patients were aged ≥9 years, prescribed an oral antibiotic, and diagnosed with acne vulgaris on 2 separate occasions. The primary outcome was the duration of oral antibiotic treatment over 12 months; continuous use was defined as ≤30-day gap between prescriptions. Results: The most commonly prescribed antibiotic treatments (N=46,267) were doxycycline (36.7%) and minocycline (36.5%). Overall, 36%, 18%, 10%, and 5% of patients continuously used any Do oral Not antibiotic Copyat 3, 6, 9, and 12 months, respectively. Among patients who continuously used tetracyclines, a similar percentage was Penalties prescribedApply minocycline (40.2%, 18.6%, 10.5%, and 5.1%) vs doxycycline (34.7%, 14.6%, 7.7%, and 3.9%) at 3, 6, 9, and 12 months, respectively. A greater percentage of patients continued use of tetracycline-class antibiotics than other therapeutic classes. Limitations: Retrospective analysis of health-care claims data. Relatively short study duration. Conclusion: Nearly 20% of patients continuously used oral antibiotics for ≥6 months, exceeding American Academy of Dermatology guideline recommendations of 3 to 4 months.