Objective: To determine if the long- term use of antibiotics for the treatment of acne results in an increase in either of 2 common infectious illnesses: upper respiratory tract infections (URTIs)or urinary tract infections. Design: Retrospective cohort study. Setting: General Practice Research Database of the United Kingdom, London, England, from 1987 to 2002. Patients: Patients with a diagnosis of acne. Main Outcome Measure: The onset of either a URTI or a urinary tract infection. Results: Of 118 496 individuals with acne (age range, 15- 35 years) who were identified in the General Practice Research Database, 84977 (71.7% ) received a topical or oral antibiotic (tetracyclines, erythromycin, or clindamycin) for treatment of their acne and 33 519 (28.3% ) did not. Within the first year of observation, 18281 (15.4% ) of the patients with acne had at least 1 URTI, and within that year, the odds of a URTI developing among those receiving antibiotic treatment were 2.15 (95% confidence interval, 2.05- 2.23; P<.001) times greater than among those who were not receiving antibiotic treatment. Multiple additional analyses, which were conducted to show that this effect was not an artifact of increased health care- seeking behavior among our cohorts, included comparing the cohorts of patients with acne with a cohort of patients with hypertension and the likelihood of developing a urinary tract infection. Conclusions: Patients with acne who were receiving antibiotic treatment for acne were more likely to develop a URTI than those with acne who were not receiving such treatment. The true clinical importance of our findings will require further investigation.
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