A recent study found high levels of antibiotic resistance among bacterial growths collected from patients with (HS) hidradenitis suppurativa. This included resistance to rifampicin, clindamycin, and tetracyclines, which are cited as an empiric choice in HS therapeutic guidelines, the researchers said.
In the study, the researchers collected purulent material from 137 skin lesions of patients with HS, including samples from the axillae, groin, and perianal areas. They assessed bacterial floral and antibiotic sensitivity using microbiological cultures for aerobic and anaerobic bacteria. The primary outcome included the prevalence of antibiotic resistant bacterial growths.
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Overall, 114 samples tested positive for bacteria and a total of 163 single bacterial growths were observed. Of these growths, 55% were gram-positive, 44% were gram-negative, and 18.5% were anaerobic.
The most frequent bacterial families the researchers observed included enterobacteriaceae (30.7%), staphylococcus (25.2%), and streptococcus (14.1%), and the most frequent genus were Proteus spp (13.5%) and E coli (9.8%).
In addition, the prevalence of antibiotic resistance was clindamycin 65.7%, rifampicin 69.3%, penicillin 70.0%, ciprofloxacin 74%, tetracycline 84.7% and erythromycin 89.0%. One limitation of the study, the researchers noted, was the short cultural period that could have impaired the isolation of anaerobic bacteria.
“A targeted and specific antibiotic therapy, driven by microbiological evaluations with prolonged culture periods, seems more appropriate than empiric, generic, non‐specific, therapeutic approaches,” the researchers concluded. “Current knowledge regarding HS bacterial antibiotic resistance should be considered in the update of current therapeutic guidelines for HS.”
Bettoli V, Manfredini M, Massoli L, et al. Rates of antibiotic resistance/Sensitivity in bacterial cultures of hidradenitis suppurativa patients [published online November 5, 2018]. J Eur Acad Dermatol Venereol. https://doi.org/10.1111/jdv.15332