P Y Başak1, E S Cetin, I Gürses, A G Ozseven. 1. Department of Dermatology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey Department of Microbiology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey Dermatologist, Kırıkkale State Hospital, Kirikkale, Turkey Department of Microbiology, Faculty of Medicine, Resident, Süleyman Demirel University, Isparta, Turkey.
Abstract
BACKGROUND: Although there are several studies about the alteration in skin flora, limited number of reports about changes in the microbial contents and their resistance profile of other body sites in patients treated with isotretinoin for acne vulgaris. OBJECTIVES: The aim of this study was to investigate the effects of systemic isotretinoin and antibiotic therapy on the microbial floras of oropharynx, nose and feces in acne patients. METHODS: Treatment groups of isotretinoin and antibioticsconsisting of 20 and 15 patients, respectively were included. Microbiological culture samples were taken at baseline and once a month during 4-6 months of treatment period. RESULTS: Difference in microbial flora throughout the treatment period was detected at least among one of all culture samples of 15 (75%) and 5 (33%) patients in isotretinoin and antibiotic groups. There was statistically significant difference between two groups in means of alteration of the microbial flora (P = 0.013). The difference was definitely observed among nasal cultures (65%) in isotretinoin group and fecal cultures (20%) in the other. Staphylococcus aureus colonization was prominent in the microbial floras of nose and oropharynx and 2 of 14 nasal isolates were detected to be methicilline resistant while Escherichia coli with extended spectrum beta lactamase activity was detected in fecal floras of patients in isotretinoin group. CONCLUSIONS: Systemic isotretinoin and antibiotic treatments in acne patients precisely caused variations in the microbial floras of several sites of the body, while isotretinoin was commonly more responsible than antibiotics. Knowing that alterations in the microbial colonization of the flora regions may preceede infectious disease and bacterial resistance, treatment options and follow-up procedures in acne vulgaris should be carefully determined to reduce the risk of destruction of the microbial flora.
RCT Entities:
BACKGROUND: Although there are several studies about the alteration in skin flora, limited number of reports about changes in the microbial contents and their resistance profile of other body sites in patients treated with isotretinoin for acne vulgaris. OBJECTIVES: The aim of this study was to investigate the effects of systemic isotretinoin and antibiotic therapy on the microbial floras of oropharynx, nose and feces in acnepatients. METHODS: Treatment groups of isotretinoin and antibiotics consisting of 20 and 15 patients, respectively were included. Microbiological culture samples were taken at baseline and once a month during 4-6 months of treatment period. RESULTS: Difference in microbial flora throughout the treatment period was detected at least among one of all culture samples of 15 (75%) and 5 (33%) patients in isotretinoin and antibiotic groups. There was statistically significant difference between two groups in means of alteration of the microbial flora (P = 0.013). The difference was definitely observed among nasal cultures (65%) in isotretinoin group and fecal cultures (20%) in the other. Staphylococcus aureus colonization was prominent in the microbial floras of nose and oropharynx and 2 of 14 nasal isolates were detected to be methicilline resistant while Escherichia coli with extended spectrum beta lactamase activity was detected in fecal floras of patients in isotretinoin group. CONCLUSIONS: Systemic isotretinoin and antibiotic treatments in acnepatients precisely caused variations in the microbial floras of several sites of the body, while isotretinoin was commonly more responsible than antibiotics. Knowing that alterations in the microbial colonization of the flora regions may preceede infectious disease and bacterial resistance, treatment options and follow-up procedures in acne vulgaris should be carefully determined to reduce the risk of destruction of the microbial flora.
Authors: J E E Totté; W T van der Feltz; L G M Bode; A van Belkum; E J van Zuuren; S G M A Pasmans Journal: Eur J Clin Microbiol Infect Dis Date: 2016-05-05 Impact factor: 3.267
Authors: Ketaki Bhate; Liang-Yu Lin; John S Barbieri; Clémence Leyrat; Susan Hopkins; Richard Stabler; Laura Shallcross; Liam Smeeth; Nick Francis; Rohini Mathur; Sinéad M Langan; Sarah-Jo Sinnott Journal: BJGP Open Date: 2021-06-30