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Comment & Response
January 10, 2017

Clinical Guidelines for Management of Acne Vulgaris—Reply

Author Affiliations
  • 1Section of Dermatology, University of Chicago, Chicago, Illinois
  • 2Section of Internal Medicine, University of Chicago, Chicago, Illinois
JAMA. 2017;317(2):213. doi:10.1001/jama.2016.19280

In Reply The guideline synopsis for the management of acne vulgaris was a summary of the clinical guideline written by the working group of the American Academy of Dermatology tasked with reviewing all the relevant evidence in a systematic manner.1 The working group established that the best evidence indicates that the efficacy of doxycycline and minocycline are indistinguishable for management of moderate to severe acne that is resistant to topical therapy. Both the guideline and a 2012 Cochrane review suggest that minocycline is more likely to cause adverse effects than other tetracyclines.2 However, the guideline writers did not think that the evidence was strong enough to withhold recommending minocycline. The risk profile of both doxycycline and minocycline are reviewed such that prescribing physicians can provide the necessary education and guidance to patients and tailor the therapy to best meet individuals’ clinical situations.

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