Rosacea and Antibiotic Resistance | Arthritis Information

 

-- Using antibiotics to treat rosacea -- a regimen that has no basis in evidence but a long history in daily clinical practice -- has contributed to antibiotic resistance, according to a review of the latest evidence. The primary suspects in this case are the tetracyclines, particularly doxycycline, explained Hilary E. Baldwin, M.D., an associate professor and vice-chair of the department of dermatology at SUNYDownstate Medical Center in New York. And, in a surprising finding, resistance to doxycycline can occur in a few days, with resistant bacteria in abundance after just seven days of treatment with 100 mg doxycyline daily, she said. Dr. Baldwin reviewed rosacea treatments during a presentation at the Skin Disease Education Foundation Hawaii Dermatology Seminar. She said that antibiotics became a standard rosacea treatment because of the mistaken belief that "the etiology of rosacea was bacterial. But the best current evidence is that microbes are not involved." Importantly, she said, "no antibiotic is FDA approved for treatment of rosacea." Yet, antibiotics continue to be a standard course because they "appear to be effective for treatment of papulopustular rosacea," she said. But tetracyclines work, Dr. Baldwin explained, not because of their antibiotic properties but because "they have anti-inflammatory activity." Specifically, tetracyclines are involved in downregulation of proinflammatory cytokines, inhibition of angiogenesis, inhibition of neutrophil chemotaxis, inhibition of nitric oxide activity, and suppression of neutrophil-derived production of reactive oxygen species -- all of which helps them take the red out of rosacea. And if one reduces the doxycycline dose to 50 mg or less a day, "you have an anti-inflammatory dose, not an antibiotic dose." But she warned that "giving 100 mg every other day, is not an anti-inflammatory dose." The 100 mg every other day actually promotes antibiotic resistance because it is starting and stopping an antibiotic regimen. Dr. Baldwin disclosed financial relationships with Allergan, Galderma, Glaxo Smith-Kline, Ortho-Neutrogena, Medicis, Ranbaxy, sanofi-aventis, and Steifel.

Primary source: Skin Disease Education Foundation Hawaii Dermatology Seminar Source reference: Baldwin HE "Everything's coming up rosey" SDEF 2009.

Lynn492009-02-17 08:36:29Wow, fascinating. It seem clear that the tetracycline antibiotics work as an anti inflammatory drug rather than as an antibiotic. Esp if you body adapts to them in a very short time, a week? Check out the dosages, sounds just like AP.

>>>But tetracyclines work, Dr. Baldwin explained, not because of their antibiotic properties but because "they have anti-inflammatory activity."


Specifically, tetracyclines are involved in downregulation of proinflammatory cytokines, inhibition of angiogenesis, inhibition of neutrophil chemotaxis, inhibition of nitric oxide activity, and suppression of neutrophil-derived production of reactive oxygen species -- all of which helps them take the red out of rosacea.


And if one reduces the doxycycline dose to 50 mg or less a day, "you have an anti-inflammatory dose, not an antibiotic dose."


But she warned that "giving 100 mg every other day, is not an anti-inflammatory dose."


The 100 mg every other day actually promotes antibiotic resistance because it is starting and stopping an antibiotic regimen.<<<Good Lord, can we say Pharma Pimp or what?

Dr. Baldwin disclosed financial relationships with Allergan, Galderma, Glaxo Smith-Kline, Ortho-Neutrogena, Medicis, Ranbaxy, sanofi-aventis, and Steifel.

Indications It is primarily used to treat acne and other skin infections as well as lyme disease as the one pill twice daily 100 mg dosage is far easier for patients than the four times a day required with tetracycline or oxytetracycline. Although minocycline's broader spectrum of activity, compared to other members of the group, includes activity against Neisseria meningitidis, its use as a prophylaxis is no longer recommended because of side effects (dizziness and vertigo). It may be used to treat certain strains of MRSA infection and disease caused by drug resistant Acinetobacter. Minocycline is recognized as a DMARDS (Disease-Modifying Antirheumatic Drug) by the American College of Rheumatology, which recommends its use as a treatment for mild rheumatoid arthritis. For other uses of minocycline see Tetracycline antibiotics and oxytetracycline as the uses are much the same between Tetracyclines with only minor exceptions.

Is that all you have to say?

Because I look at you as a AP pimp, er pip.

>>>Good Lord, can we say Pharma Pimp or what?>> [QUOTE=Bird Girrl]Wow, fascinating. It seem clear that the tetracycline antibiotics work as an anti inflammatory drug rather than as an antibiotic. Esp if you body adapts to them in a very short time, a week? Check out the dosages, sounds just like AP.

>>>But tetracyclines work, Dr. Baldwin explained, not because of their antibiotic properties but because "they have anti-inflammatory activity."


[/QUOTE]

Isn't it great that they work!  As you said,  "it seems clear".

I hadn't opened this thread about rosacea and wasn't sure why it was posted on an RA board, but now I take it that it was to support AP. 

Is there a link to the article, Lynn?  I didn't see posted what the dr. recommends for rosacea in place of doxycycline.
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