Objective: Aim 1: Characterize the international distribution of oral antibiotic use for acne in the pediatric and young adult population ages 12 to 21. Aim 2: Characterize the international distribution of oral antibiotic use for acne in the adult population ages 22 to 60.
Rationale: Acne is a common and disabling medical condition, particularly amongst adolescents and young adults. According to the Global Burden of Disease Study 2016, acne is the most disabling skin condition worldwide, responsible for 0.28% of global burden from all diseases. In addition to physical disfigurement, the profound psychosocial effects of acne have been recognized for over half a century. Guidelines established by the American Academy of Dermatology recommend minimizing the duration of systemic antibiotics for the management of acne ideally to 3-4 months and no longer than 6 months in order to decrease risk of resistance. A recent systematic review demonstrated that over 50% of P. acnes strains are reported as resistant in all major regions of the world. In addition to promoting resistance, long-term oral antibiotic use has been associated with a number of adverse events including microbiome disruption and pharyngitis, as well as possible associations with inflammatory bowel disease and obesity. Despite these adverse effects, oral antibiotics are often prescribed for acne for longer durations than acne guidelines recommend. A large retrospective cohort study of teenagers in the UK revealed that 29% of antibiotic courses prescribed by general practitioners exceeded 6 months in duration. A similar retrospective cohort study of teenagers and young adults in the US found that 18% of antibiotic courses exceeded 6 months. Our study will investigate oral antibiotic use for acne over the last ten years across the globe in both pediatric/young adult and adult populations. OHDSI network evidence will identify areas of the globe most in need of improving guideline concordance.
Project Lead(s): Chante Karimkhani, Robert P. Dellavalle, Lisa M. Schilling
Coordinating Institution(s): University of Colorado School of Medicine
Full Draft Protocol: Please provide any comments or suggestions. https://docs.google.com/document/d/1baPHccNGfQtUNEY-bzIqTGGz7E8zbMBS_62nKDI8kGo/edit#
Initial Proposal Date: 25 August 2016
Study Closure Date:
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