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Journal of the American Academy of Dermatology
Volume 71, n° 1
pages 70-76 (juillet 2014)
Doi : 10.1016/j.jaad.2014.02.031
accepted : 26 February 2014
Original Articles

A retrospective analysis of the duration of oral antibiotic therapy for the treatment of acne among adolescents: Investigating practice gaps and potential cost-savings

Young H. Lee, MD a, , Guodong Liu, PhD b, Diane M. Thiboutot, MD a, Douglas L. Leslie, PhD b, Joslyn S. Kirby, MD a
a Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania 
b Division of Health Services Research, Department of Public Health Sciences, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania 

Reprint requests: Young H. Lee, MD, Penn State Milton S. Hershey Medical Center, 500 University Drive, UPC II Suite 4300 MC HU14, Hershey, PA 17033.

Duration of oral antibiotic therapy in acne has not been widely studied. Recent guidelines suggest it should be limited to 3 to 6 months.


We sought to compare the duration of oral antibiotic use with recent guidelines and determine the potential cost-savings related to shortened durations.


This is a retrospective cohort study from the MarketScan Commercial Claims and Encounters database. Claims data were used to determine duration and costs of antibiotic therapy.


The mean course duration was 129 days. The majority (93%) of courses were less than 9 months. Among the 31,634 courses, 18,280 (57.8%) did not include concomitant topical retinoid therapy. The mean (95% confidence interval) duration with and without topical retinoid use was 133 (131.5-134.7) days and 127 (125.4-127.9) days, respectively. The mean excess direct cost of antibiotic treatment for longer than 6 months was $580.99/person.


Claims cannot be attributed to a specific diagnosis or provider. The database does not provide information on acne severity.


Duration of antibiotic use is decreasing when compared with previous data. However, 5547 (17.53%) courses exceeded 6 months, highlighting an opportunity for reduced antibiotic use. If courses greater than 6 months were shortened to 6 months, savings would be $580.99/person.

The full text of this article is available in PDF format.

Key words : acne treatment, acne vulgaris, costs, oral antibiotics, topical retinoids, treatment guidelines

 An American Acne and Rosacea Society Clinical Research Grant funded the research, but the society had no input into the preparation of this manuscript.
 Disclosure: Dr Thiboutot has served as a consultant and investigator for Allergan, Galderma, Intrepid, and Stiefel/GSK. Drs Lee, Liu, Leslie, and Kirby have no conflicts of interest to declare.

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