Acne is one of the most common diseases worldwide and affects ∼50 million individuals in the United States. Oral antibiotics are the most common systemic agent prescribed for the treatment of acne. However, their use might be associated with a variety of adverse outcomes including bacterial resistance and disruption of the microbiome. As a result, multiple treatment guidelines call for limiting the use of oral antibiotics in the treatment of acne, although actual prescribing often does not follow these guidelines. In this review, the rationale for concerns regarding the use of oral antibiotics for the management of acne is reviewed. In addition, we will discuss our approach to complying with the intent of the guidelines, with a focus on novel topical agents, dietary modification, laser and light-based modalities, and systemic medications, such as spironolactone, combined oral contraceptives, and oral isotretinoin.

中文翻译：

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限制痤疮全身抗生素使用的方法：全身替代方案、新兴局部疗法、饮食调整以及激光和光治疗。


痤疮是全世界最常见的疾病之一，在美国影响约 5000 万人。口服抗生素是治疗痤疮最常见的全身药物。然而，它们的使用可能与各种不良后果有关，包括细菌耐药性和微生物组破坏。因此，多种治疗指南要求限制口服抗生素在痤疮治疗中的使用，尽管实际处方通常不遵循这些指南。在这篇综述中，回顾了对使用口服抗生素治疗痤疮的担忧的理由。此外，我们将讨论遵守指南意图的方法，重点是新型外用药物、饮食调整、激光和光疗法以及全身药物，例如螺内酯、复方口服避孕药和口服异维A酸。