Long-Term Macrolide Use Increases Risk of Resistant P acnes

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A2059 mutants showed high-level resistance to macrolides but low-level resistance to clindamycin.
A2059 mutants showed high-level resistance to macrolides but low-level resistance to clindamycin.

HealthDay News — Long-term oral macrolide administration may increase macrolide-resistant Propionibacterium acnes, according to a study published in the Journal of Dermatology.

Keisuke Nakase, from the Tokyo University of Pharmacy and Life Sciences, and colleagues examined the mutation frequency of macrolide resistance in P acnes in vitro.

The researchers found that resistant mutants with the 23S rRNA mutation were not isolated when P acnes mutants were exposed to clarithromycin after being incubated in broth without antimicrobials. After being pre-incubated with 0.03 µg/mL of antimicrobials, the mutants were obtained at the frequency of 10−6

The 23S rRNA mutations A2058G, A2059G, and C2611G were harbored by the resistant mutants. C2611G mutants, which showed resistance to clarithromycin, were obtained 32.1% more often when pre-incubated with clarithromycin vs clindamycin. A2058G mutants, which show high-level resistance to clarithromycin and clindamycin, were more often obtained when pre-incubated with clindamycin vs clarithromycin (87.5%). There was no difference in the isolation rate of A2059G mutants with either treatment; A2059 mutants showed high-level resistance to macrolides but low-level resistance to clindamycin.

"These results indicate the possibility that long-term use of oral macrolides for acne treatment facilitate the increase of macrolide-resistant P acnes," the authors write.

Disclosures: The study was partially supported by Pfizer.

Reference

Nakase K, Okamoto Y, Aoki S, Noguchi N. Long-term administration of oral macrolides for acne treatment increases macrolide-resistant Propionibacterium acnes [published online December 13, 2017]. J Derm. doi: 10.1111/1346-8138.14178.

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