Potential harms of long-term acne treatment with oral antibiotics

摘要

Specific evidence attributing adverse effects to longterm acne treatment with oral antibiotics is lacking. However, nausea, vomiting, or diarrhea are seen in 7% of patients taking tetracyclines, 4% taking macrolides, and 2% taking clindamycin. Tetracyclines also cause dizziness, headache, and photosensitivity in 2% of patients (strength of recommendation [SOR] A: based on meta-analyses of randomized controlled trials [RCTs]). In addition, tetracyclines are associated with rare hypersensitivity reactions (pneumonitis, eosinophilic nephritis, serum sickness) and intracranial hypertension (SOR C: based on case reports). Minocycline might increase the risk of systemic lupus erythematosus (SLE), autoimmune hepatitis, and polyarteritis nodosa, generally after 1 year of use (SOR B: based on retrospective cohort and case-control studies). Macrolides are associated with cardiac conduction abnormalities and, rarely, hepatotoxicity. Clindamycin is associated with pseudomembranous colitis (SOR C: based on case reports).