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Do Dermatologists Prescribe Too Many Antibiotics?

Were you ever prescribed antibiotics for a cold? What about acne? Millions of teenagers may have received too many antibiotics. Are there long-term effects?

Dermatologists love antibiotics. They prescribe proportionately more antibiotics than other medical specialties. Do not take our word for this! Here is a quote from an article in JAMA Dermatology (Jan. 16, 2019): “Dermatologists prescribe more oral antibiotic courses per clinician than any other specialty, and this use puts patients at risk of antibiotic-resistant infections and antibiotic-associated adverse events.” One might conclude from this study that dermatologists do indeed prescribe too many antibiotics.

Too Many Antibiotics and Acne?

Frequently, dermatologists prescribe antibiotics to treat non-infectious conditions such as acne or rosacea. It’s not unusual for a teenager to be prescribed a tetracycline-type antibiotic for years to control blemishes.

In the good old days no one worried about too many antibiotics. Many physicians looked upon such drugs as magic bullets. They were thought to be very safe, even when taken for long periods of time. They were often prescribed for viral infections like colds or flu, even though antibiotics cannot do anything to shorten a viral infection.

Now we know that there are unexpected complications from too many antibiotics. For one thing, such drugs can disrupt the microbiome. And we’re not just talking about the bacteria in the digestive tract. The microbiome of the skin, mouth, lungs and vaginal tract can also be affected (Biochemical Pharmacology, June 15, 2017). We are only beginning to understand the ramifications of the disruptions to our bacterial ecology. Sometimes these changes can last for years (Journal of Antimicrobial Chemotherapy, Nov. 12, 2018).

The scientists who wrote the article in JAMA Dermatology noted:

“This antibiotic use can have clinical consequences, including the development of antimicrobial resistance. Oral antibiotic therapy in the treatment of acne is associated with disruption of the normal oropharyngeal [mouth and throat] flora and resultant pharyngitis.”

They go on to conclude:

“Continuing to develop alternatives to oral antibiotics for noninfectious conditions, such as acne, can improve antibiotic stewardship and decrease complications from antibiotic use.”

Taking Antibiotics with Respect:

Frequent antibiotic use can lead to bacteria developing resistance, so the news from a new study in JAMA Dermatology is encouraging. Between 2008 and 2016, dermatologists prescribed fewer antibiotics overall, dropping from 3 to 2 prescriptions per 100 visits. Antibiotic prescriptions rose, however, for surgical procedures and cysts.

Do you think you were ever prescribed too many antibiotics? Please share your story in the comment section below.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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