Tetracycline Antibiotics

Tetracycline Antibiotics For Acne Treatment

Discovered in the late 1940s, Tetracyclines are a family of broad spectrum antibiotics used to treat a wide range of bacterial infections. The original tetracyclines were derived from Streptomyces bacteria, but the newer derivatives are semisynthetic.

The tetracycline antibiotics are the workhorses in oral acne therapy. They're the first-line oral antibiotic drugs of choice in the management of moderate to severe acne. They were first widely prescribed by dermatologists in the early 1950s when it was discovered that they were effective as a treatment for acne.

Oral antibiotics work to reduce the P. acnes population (a contributing factor in acne), which, in turn, decreases inflammation.

Tetracyclines exert their bacteriostatic effect by inhibiting protein synthesis in bacteria. In addition to these antibacterial effects, tetracyclines have strong anti-inflammatory properties.

Tetracycline is the most widely prescribed antibiotic for acne. A typical tetracycline regimen for treating moderate to severe acne starts with a dose of 500 to 1000 milligrams a day, which is decreased as improvement occurs. Long-term, low-dose tetracycline therapy may be continued for many months to suppress acne. Higher doses may be prescribed for very severe acne. The main drawback for this antibiotic is that it must be taken on an empty stomach to be the most effective.

Two synthetic derivatives of tetracycline used to treat acne are doxycycline and minocycline.

Doxycycline proves especially effective in treating inflammatory acne. This antibiotic is often used for people who do not respond to or cannot tolerate erythromycin or tetracycline. The dosage of doxycycline is started at 50 to 100 mg twice a day. It should be taken with food, otherwise it can cause significant nausea. Doxycycline is more likely than tetracycline to increase sensitivity to the sun, or cause sunburns.

Minocyline has a long history of use in treating acne. It is often effective in treating acne that has not responded to other oral antibiotics. Minocycline is especially useful for pustular type acne. It also seems to produce fewer incidents of antibiotic resistance. However, minocycline accounts for serious side effects more frequently than other tetracyclines.

In particular, this drug may cause rare but seriouse side effects such as lupus-like syndrome, serum sickness like reaction (SSLR) and secondary intracranial hypertension.