Should we consider broad‐spectrum quinolone antibacterial agent as acne treatment in the antimicrobial resistance era?

Should we consider broad-spectrum quinolone antibacterial agent as acne treatment in the antimicrobial resistance era? The range of MICs reported was quite low, but it has been recently described fluoroquinolone-resistant strains, especially in Japan.5 Moreover, we know that (i) I C. acnes i can exhibit a low-level or a high-level fluoroquinolone resistance,6 (ii) it is easy to select a high-level resistance from a low-level resistance strain and (iii) the more broad-spectrum antibiotics are used, the greater the risk of selecting resistant mutants is. I epidermidis i inhibits I C. acnes i growth by antimicrobial peptides or by releasing succinic acid and controlling I C. acnes i -induced inflammation).11 In conclusion, the best strategy to prevent antimicrobial resistance remains to limit as far as possible the antibiotic treatment in acne disease, especially the broad-spectrum ones. [Extracted from the article]