Antibiotic Monotherapy Shows Promise for HS



Clindamycin monotherapy was associated with improvements in hidradenitis suppurativa (HS) symptoms, according to the findings of a recent study.

In the study, the researchers classified 60 participants with HS using International Hidradenitis Suppurative 4 (IHS4) and Hurley scores from mild to moderate to moderate to severe. Participants were divided evenly into 2 groups and received either combination clindamycin and rifampicin (group A) or clindamycin alone (group B). Clinical and ultrasound response between groups after 8 weeks of treatment using the Hidradenitis Suppurativa Clinical Response (HiSCR) was assessed as the primary outcome.
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After 8 weeks of treatment, 17 participants in group A and 19 participants in group B met the primary outcome. While both groups showed similar improvements on IHS4, participants in group B experienced greater improvements on the Dermatology Quality of Life Index and Pain Visual Analog Scale.

Nodules and abscesses count reductions were similar between groups, as well as disease-free survival. However, the number of draining tunnels decreased more among participants in group B.

The researchers found that HiSCR was significantly associated with age, body mass index, IHS4, and absence of axillary involvement. 

One limitation was that it was not a randomized or placebo-controlled trial, the researchers noted.

“Clindamycin may be a useful treatment alternative to antibiotic combination regardless of HS clinical stage,” the researchers concluded.


Caro RDC, Cannizzaro MV, Botti E, et al. Clindamycin versus clindamycin plus rifampicin in hidradenitis suppurativa treatment: clinical and ultrasound observations [published online November 28, 2018]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.11.035