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Has There Been a Change in Spironolactone Prescribing for Acne?

Oral antibiotics and spironolactone prescribed at about the same frequency in 2020 compared with more antibiotics in 2017

By Dermsquared Editorial Team | August 23, 2023

WEDNESDAY, Aug. 16, 2023 -- Trends in prescribing for acne include an increase in spironolactone prescribing, which was prescribed at about the same frequency as oral antibiotics in 2020, according to a research letter published online Aug. 16 in JAMA Dermatology.

John S. Barbieri, M.D., from Brigham and Women's Hospital in Boston, conducted a repeated cross-sectional study to examine recent trends in prescriptions of oral tetracycline antibiotics (doxycycline, minocycline), other commonly prescribed oral antibiotics (trimethoprim-sulfamethoxazole, amoxicillin, cephalexin), spironolactone, and isotretinoin for individuals with acne.

Barbieri found that during 2017 through 2020, there was an approximately threefold to fourfold increase in prescribing of spironolactone among dermatologists, nurse practitioners (NPs) or physician assistants (PAs), and nondermatology physicians. In 2017, oral antibiotics were prescribed about twofold to threefold more often than spironolactone, while in 2020, they were prescribed at about the same frequency; nondermatology physicians and NPs or PAs prescribed oral antibiotics slightly more frequently in 2020. During the study period, isotretinoin prescribing decreased slightly across both male and female patients. While overall prescribing increased across all antibiotic types, the rate of increase was higher for doxycycline versus minocycline, especially among dermatology physicians and NPs or PAs.

"Oral antibiotics continued to be frequently prescribed by both dermatologists and nondermatologists, which emphasizes the need for continued efforts to identify nonantibiotic treatment options for acne, particularly as many patients are interested in these options," Barbieri writes.

Barbieri disclosed receiving consulting fees from Dexcel Pharma.


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