Journal of Antimicrobial Chemotherapy (1996) 38, 829-837
© 1996 The British Society for Antimicrobial Chemotherapy
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Sequential antibiotic therapy for acne promotes the carriage of resistant staphylococci on the skin of contacts
aDepartments of Microbiology, University of Leeds Leeds LS2 9JT cStatistics, University of Leeds Leeds LS2 9JT bDepartment of Microbiology, Chapel Allerton Hospital Chapeltown Road, Leeds LS7 4SA dDepartment of Dermatology, Leeds General Infirmary Leeds LSI 3EX, UK
Received 4 March 1996; returned 27 March 1996; accepted 10 June 1996
*Corresponding author. Tel: +44-113-233-5631; Fax: +44-113-233-5638
The selection of a predominantly resistant staphylococcal skin flora in acne patients during antibiotic treatment has been extensively documented. This study sought to determine whether antibiotic therapy for acne had any effect on skin carriage of resistant coagulase-negative staphylococci (CNS) by close contacts of treated patients. Bacterial samples were obtained using a scrub wash technique from facial skin of 41 contacts (parents, siblings or partners) of patients who had been treated with at least three different antibiotics over a minimum period of 2 years. Samples were also obtained from 41 control subjects who had no known contact with any antibiotic treated acne patient. None of the contacts or controls had received any antibiotic therapy in the preceding two years. The number, percentage and prevalence of CNS resistant to each of seven antibiotics was estimated by plating serial ten-fold dilutions of wash fluid directly onto antibiotic-containing and antibiotic-free medium. Significantly more contacts than controls carried strains resistant to erythromycin, clindamycin, fusidic acid, trimethoprim and chloramphenicol as well as more multiply resistant strains (P<0.05, x2)- The number and percentage of staphylococci resistant to tetracycline, erythromycin, clindamycin, fusidic acid and chloramphenicol were also significantly raised (P<0.05, Mann-Whitney U-test) in contacts. Only aminoglycoside resistance was not increased by any of the above criteria. These observations provide evidence that sequential antibiotic therapy for acne exerts selective pressure for increased skin carriage of resistant CNS not only in patients but also in their close contacts.
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