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May 1980

Topical Treatment of Gram-Negative Bacterial Suprainfection in Acne

Author Affiliations

From the Palm Beach Medical Group, West Palm Beach, Fla.

Arch Dermatol. 1980;116(5):597. doi:10.1001/archderm.1980.01640290107027

Suprainfection with Gram-negative bacteria is a well-known complication of cystic acne in patients treated with long-term broad-spectrum oral antibiotics. As observed by Leyden et al1,2 and Fulton et al,3 numerous organisms are found in these cysts. We report here a case of such infection controlled with a simple topical medication.

Report of a Case  A 15-year-old boy with cystic acne on his back and papules on his face was seen in March 1976. He began taking 250 mg of tetracycline hydrochloride four times a day and applying 0.025% tretinoin gel to his face and back every night and 5% benzoyl peroxide to his face only. During the next 17 months, he was under the care of a dermatologist in Michigan who continued the oral tetracycline therapy but switched to a topical benzoyl peroxide-sulfur lotion, plus a topical clindamycin solution. The patient's acne condition stabilized, but it was not

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