Spread of antibiotic-resistant bacteria from acne patients to personal contacts-a problem beyond the skin?

For at least a decade, concern has been raised regarding the emergence of antibiotic-resistant skin flora in acne patients receiving long-term topical or oral antibiotic therapy.1 Most studies have focused on two microorganisms, Propionibacterium acnes and coagulase-negative staphylococci, including Staphylococcus epidermidis. For example, the topical application of erythromycin has been associated with an overgrowth of erythromycin-resistant coagulase-negative staphylococci,2 and strains of P acnes resistant to tetracycline and/or erythromycin were isolated from acne patients who had received long-term antibiotic therapy.