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Characterization of Oral Antibiotics for Acne Treatment
Objective: Aim 1: Characterize the international distribution of oral antibiotic use for acne in the pediatric and young adult population ages 12 to 20. Aim 2: Characterize the international distribution of oral antibiotic use for acne in the adult population ages 21 to 40.
Rationale: Acne is a common and disabling medical condition, particularly amongst adolescents and young adults.[1] 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.[2] In addition to physical disfigurement, the profound psychosocial effects of acne have been recognized for over half a century.[3] 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.[1] A recent systematic review demonstrated that over 50% of P. acnes strains are reported as resistant in all major regions of the world.[4] 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.[5] Despite these adverse effects, oral antibiotics are often prescribed for acne for longer durations than acne guidelines recommend.[5] 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.[5] A similar retrospective cohort study of teenagers and young adults in the US found that 18% of antibiotic courses exceeded 6 months.[6] 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): Robert P. Dellavalle, Lisa M. Schilling
Coordinating Institution(s): University of Colorado School of Medicine
Additional Participants: Chante Karimkhani: ck2525@caa.columbia.edu Chandler Rundle: chandler.rundle@gmail.com Megan Branda: MEGAN.BRANDA@cuanschutz.edu John Barbieri: john.barbieri@uphs.upenn.edu Chris Knoll: cknoll1@its.jnj.com David Margolis: margo@mail.med.upenn.edu Patrick Ryan: ryan@ohdsi.org Martijn Schuemie: m.schuemie@erasmusmc.nl Jonathan Silverberg: JonathanISilverberg@gmail.com Dylan Ray: DYLAN.RAY@cuanschutz.edu Sara Deakyne: Sara.DeakyneDavies@childrenscolorado.org
Full Draft Protocol: Please provide any comments or suggestions. https://docs.google.com/document/d/1LnugUQrloOn-3cZJDdTpgVYEsynu7SBztFtjzjAuEDE/edit
Initial Proposal Date: 25 August 2016
Launch Date:
Study Closure Date:
Forum Discussion Thread
http://forums.ohdsi.org/t/ohdsi-study-concordance-with-antibiotic-treatment-guidelines-for-acne/1703
