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January 16, 2019

Dermatologists and Antibiotics—Reflecting on Our Habits, the Evidence, and Next Steps

Author Affiliations
  • 1Department of Dermatology, Penn State Hershey, Hershey, Pennsylvania
JAMA Dermatol. 2019;155(3):286-287. doi:10.1001/jamadermatol.2018.4877

We see a young woman with moderate inflammatory acne—click, doxycycline.

We see a woman with Hurley stage II hidradenitis suppurativa (HS) that did not respond to doxycycline treatment—click, clindamycin and rifampin.

We see a man with a ruptured epidermal inclusion cyst (EIC)—click, cephalexin.

A series of quick clicks, and treatment is delivered, but are all these antibiotics necessary? The article in this issue by Barbieri et al1 calls attention to our prescribing habits, which, left unchecked, would have us continue to prescribe more oral antibiotics per clinician than practitioners in any other medical discipline. On a positive note, between 2008 and 2016, overall antibiotic prescribing rates among dermatologists decreased by 36.6%; however, there were increases in short-term antibiotic use related to surgical procedures and cysts as well as room to continue to improve with prescribing of long-term antibiotics for conditions such as acne, rosacea, and HS.1