Acne Management: Antibiotic Stewardship and Optimizing Isotretinoin Treatment

ABSTRACT Purpose: Address practice gaps in the treatment of moderate to severe acne in the context of antibiotic stewardship by considering the optimization of Isotretinoin as a treatment alternative to traditional antibiotic use. Methods: The literature search for this review was performed using the PubMed database. The advanced search and clinical queries links were used to search terms: acne [Mesh] OR acne vulgaris [Mesh] AND acne treatment AND antibiotic stewardship AND antibiotic resistance AND Isotretinoin. The results were selected for meta-analysis, randomized controlled trials [RCT], and articles published in the last five years to further define the search. Results: Acne vulgaris (acne) is a chronic skin condition affecting millions worldwide and represents one of the most common dermatologic complaints. Systemic antibiotic treatment has been a mainstay in moderate to severe acne management for the past 40 plus years. With the growing emergence of antibiotic resistance worldwide, there is a global concern that antibiotic acne treatment may be contributing to this burden. Isotretinoin is emerging as a non-antibiotic treatment of choice for moderate to severe acne vulgaris. Conclusion: Antibiotic resistance has become a growing concern worldwide. The emergence and potential transfer of antibiotic resistance in skin microorganisms demand the limited and judicious use of antibiotics to treat acne and warrant further investigation into the relationship. Isotretinoin represents a non-antibiotic alternative for the treatment of acne vulgaris. Keywords: acne vulgaris, acne, acne treatment, antimicrobial resistance, antibiotic resistance, antibiotic stewardship, Isotretinoin