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Cutis. 2008 Dec;82(6):417-21.

Antibiotic-resistant Propionibacterium acnes suppressed by a benzoyl peroxide cleanser 6%.

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Department of Dermatology, University of Pennsylvania, Philadelphia, USA.


Adding topical benzoyl peroxide (BPO) to antibiotics can reduce resistant Propionibacterium acnes in patients with acne receiving antibiotic therapy. Benzoyl peroxide often is formulated as a wash, but no published data exist regarding BPO wash formulation efficacy in reducing resistant strains of P acnes. This 3-week, open-label, single-center study evaluated the effects of BPO cleanser 6% on antibiotic-resistant P acnes populations. The study involved 30 healthy adults who were free of acne but had high facial P acnes populations (10,000 colonies/cm2 or more) resistant to erythromycin and tetracycline at 8 microg/mL or more and 2 microg/mL or more, respectively. Participants applied BPO cleanser 6% once daily. Quantitative P acnes cultures were obtained at baseline and weekly for 3 weeks. At baseline, resistance to erythromycin, tetracycline, doxycycline, minocycline, and clindamycin was present in 100% (30/30), 97% (29/30), 83% (25/30), 63% (19/30), and 100% (25/25) of participants, respectively, high-level resistance for erythromycin and tetracyclines and intermediate to high resistance for clindamycin was present in 100% (30/30), 50% (15/30), 33% (10/30), 27% (8/30), and 52% (13/25) of participants, respectively. Total P acnes counts and counts of each resistant strain decreased by approximately 1 log after 1 week of treatment, by at least 1.5 log after 2 weeks of treatment, and by at least 2 log after 3 weeks of treatment, with no differences between resistant and susceptible strains or between highly resistant and low-level resistant strains. Benzoyl peroxide cleanser 6% effectively reduced resistant P acnes populations and offers a useful therapy for controlling antibiotic resistance in patients receiving antibiotics.

[Indexed for MEDLINE]

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