Antibiogram in Cutibacterium Acnes: A Comprehensive Study of Oral and Topical Treatments for Acne in the Indian Population

Injudicious antibiotic therapy in acne has resulted in significant dissemination of cross-resistant strains of Cutibacterium acnes (C. acnes). Resistance patterns vary in different studies, corresponding to the geographic location, and study methods. Prior studies have shown a high resistance to azithromycin, erythromycin and clindamycin and high sensitivity to macrolide antibiotics. There is a paucity of studies evaluating the efficacy of topical anti-acne agents.Our objective was to isolate C.acnes from acne lesions ,and to evaluate the antibiotic susceptibility of oral and topical antibiotics in acne. As antibiotic sensitivity patterns vary with time and prescribing practices, our study aimed to evaluate these patterns, as there is limited data available on Antimicrobial resistance(AMR) in India. Swabs from acne pustules from 124 patients, aged 12 years and above, were obtained and inoculated into selective media for C. acnes and blood agar for isolation of aerobic organisms, gram staining and species identification of Cutibacterium. The isolated bacteria were cultured and evaluated for antibiotic sensitivity using standard disc diffusion techniques. Statistical analysis was performed on SPSS23 software. In our study, the average age of the patients was 21.34 ± 4.2 years, a majority (63.7%) were females. Cutibacterium was isolated in 74.19% of patients. Among oral antibiotics minocycline was the most sensitive to C. acnes (97%); the highest resistance to C. acnes was seen with erythromycin (84%). Topically, benzoyl peroxide had higher sensitivity (48%), and adapalene (95%) and azelaic acid (83%) showed the least antimicrobial activity against C. acnes.The results prove that sensitivity patterns to oral antibiotics remain similar to previous studies. Topical Clindamycin resistance is lower than previously reported resistance rates. Topical benzoyl peroxide showed lower antimicrobial activity in comparison to prior studies. AMR in acne continues to be a concern. Hence the need to maintain stringent guidelines for antibiotic usage in acne.