Antibiotic susceptibility of <i>Propionibacterium acnes</i> isolated from patients with acne in a public hospital in Southwest China: prospective cross-sectional study.

Abstract

Antibiotics have been routinely used for several decades against <i>Propionibacterium acnes</i> (<i>P. acnes</i>), but antibiotic resistance of <i>P. acnes</i> is becoming a global problem. Only one related Chinese study is available. The aim of this study was to assess the antibiotic susceptibility of <i>P. acnes</i> obtained from patients with acne in Southwest China. This was a prospective cross-sectional study. Cutaneous samples were obtained from acne lesions on the face of 375 patients. Samples were cultured in anaerobic medium to identify the presence of <i>P. acnes</i>. Susceptibility tests of isolated <i>P. acnes</i> were performed for tetracycline, doxycycline, clindamycin, erythromycin, azithromycin and clarithromycin using the Epsilometer test. <i>P. acnes</i> was isolated from 227 patients; 224 isolates (98.7%) were susceptible to doxycycline and 220 (96.9%) were susceptible to tetracycline, followed by clindamycin and clarithromycin in 101 (44.5%) and 102 (44.93%) isolates, respectively. Susceptibility of <i>P. acnes</i> was detected for erythromycin in 96 (42.3%) patients, followed by azithromycin in 94 (41.4%). Subjects who received antibiotics (topical and oral) had higher frequencies of antibiotic-resistant <i>P. acnes</i> as well as increased antibiotic minimum inhibitory concentrations compared with patients without antibiotic treatment. <i>P. acnes</i> was highly sensitive to cyclines (doxycycline and tetracycline). <i>P. acnes</i> showed higher resistance rates to macrolides-lincosamides-streptogramins antibiotics (such as erythromycin, azithromycin, clarithromycin and clindamycin). The irrational use of antibiotics for acne treatment is probably a problem in China and elsewhere. These results suggest that dermatologists should be more prudent in prescribing antibiotics for acne.