Which oral antibiotics are best for acne?

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Clinical Inquiries

Which oral antibiotics are best for acne?

J Fam Pract. 2011 May;60(5):290-292

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References

1. Amin K, Riddle CC, Aires DJ, et al. Common and alternate oral antibiotic therapies for acne vulgaris: a review. J Drugs Dermatol. 2007;6:873-880.

2. Skidmore R, Kovach R, Walker C, et al. Effects of subantimicrobial-dose doxycycline in the treatment of moderate acne. Arch Dermatol. 2003;139:459-464.

3. Smith K, Leyden JJ. Safety of doxycycline and minocycline: a systematic review. Clin Ther. 2005;27:1329-1342.

4. Garner SE, Eady EA, Popescu C, et al. Minocycline for acne vulgaris: efficacy and safety. Cochrane Database Syst Rev. 2003;(1):CD002086.-

5. Gammon WR, Meyer C, Lantis S, et al. Comparative efficacy of oral erythromycin versus oral tetracycline in the treatment of acne vulgaris. A double-blind study. J Am Acad Dermatol. 1986;14:183-186.

6. Rafiei R, Yaghoobi R. Azithromycin versus tetracycline in the treatment of acne vulgaris. J Dermatol Treat. 2006;17:217-221.

7. Hurwitz S. Acne vulgaris: pathogenesis and management. Pediatr Rev. 1994;15:47-52.

8. Zaenglein AL, Thiboutot DM. Expert committee recommendations for acne management. Pediatrics. 2006;118:1188-1199.

9. Strauss JS, Krowchuk DP, Leyden JJ, et al. Guidelines of care for acne vulgaris management. J Am Acad Dermatol. 2007;56:651-663.

TABLE 2
Safety and adverse-effect profiles of acne medications⁸

Medication	Adverse effects	Pregnancy category	Lactation safety	Appropriate age range
Doxycycline hyclate	Photosensitivity, GI disturbance, elevated BUN	D	Avoid	>12 y
Minocycline	Tooth discoloration, dizziness, hypersensitivity syndrome	D	Avoid; milk effects possible	>12 y
Erythromycin base	GI disturbance, nausea	B	Safe	FDA-approved for children
Azithromycin	Abdominal pain, GI disturbance	B	Minimal risk	Extended-release formula not FDA-approved for children
BUN, blood urea nitrogen; GI, gastrointestinal.

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Which oral antibiotics are best for acne?

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