How to weigh the risks of antibiotic resistance when using topical antibiotics for acne treatment?
Thank you for your question. I think it is safe to say that you may allow your doctor to help you weigh the risks of antibiotic resistance when using topical antibiotics for acne treatment.
I personally do not recommend the use of topical antibiotics on their own for the treatment of mild-moderate papular/pustular acne - I combine topical antibiotics with topical benzoyl peroxide to reduce the risk of antibiotic resistance. This is in line with major clinical guidelines on the treatment of acne (1).
Benzoyl peroxide is a medication that may be used on its own in the treatment of acne - in fact, it has a direct bactericidal effect (kills acne bacteria) and has no risk of causing resistance.
However, both topical antibiotics and benzoyl peroxide are medications after all and come with their own possible risks and side effects (such as dryness for benzoyl peroxide). Hence, it is important to be assessed by your doctor for severity, type of acne, skin type etc. Your doctor will then consider your individual factors before discussing an appropriate treatment regime with you.
1. Acne: acne vulgaris. Primary Care Dermatology Society. http://www.pcds.org.uk/clinical-guidance/acne-vulgaris