Oral antibiotics

 

Antibiotics for acne

Antibiotic

Length of course

Contra-indications

Oxytetracycline

500mg bd

3  mth then assess

Pregnancy

Children < 12 yr

Breast-feeding

Renal disease

Cautions

Needs to be taken on an empty stomach

Monitoring

Be aware of benign intracranial hypertension -  headaches and photosensitivity

First line for acne in Primary care

Erythromycin

500mg bd

3 mth then reassess

Severe liver impairment

Significant problems with resistance

GI side-effects


Side-effects

Nausea, vomiting and diarrhoea

Oesophagitis

Candidias

GI side-effects

Lymecycline

408mg daily

3 mth then reassess

Severe renal disease

Cost of course of treatment

£6.08 for 28 days

£9.40 for 28 days

£7.16 for 28 days

Minocycline

100mg daily

3 mth then reassess

Severe liver impairment

if used for >6 mth monitor LFTs

Look for unusual skin pigmentation and SLE every 3 mth

Drug-induced hepatitis

Vestibular disturbance

Grey-blue skin discoloration

£10.57 ( as MR tab) for 28 days

Second line for acne in Primary care

Initiation in secondary care