Don't use minocycline as first line oral antibiotic in acne

doi:10.1136/bmj.39048.540394.BE

BMJ 2007;334:154 (20 January), doi:10.1136/bmj.39048.540394.BE

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Don't use minocycline as first line oral antibiotic in acne

Paul McManus, associate editor, Ike Iheanacho, editor

¹ Drug and Therapeutics Bulletin, BMA House, London WC1H 9JR

Correspondence to: P McManus PMcManus@bmjgroup.com

The first 150 words of the full text of this article appear below.

Introduction

Key points

Oral minocycline is no more effectivethan other oral tetracyclines in treating acne
The risk of rare but serious unwanted effectswith minocycline makes it less suitable for use than other drugsin its class
Oral minocycline ismore expensive than most other oral tetracyclines
Patients who need treatment with an oraltetracycline should be prescribed doxycycline, lymecycline,or oxytetracycline

The clinical problem

Most people develop acne vulgaris at some pointin life. Typified by inflammation of hair follicles and accompanyingsebaceous glands, acne may require oral antibacterial treatment,particularly in those with moderate to severe disease (an estimated11% of adolescents¹). Minocycline is a common choice of drugand is often wrongly assumed to be more effective, easier totake, and less likely to cause bacterial resistance than othertetracyclines.

We searched Medline andthe Cochrane Library to identify published randomised controlledtrials and systematic reviews that assessed the safety and . . . [Full text of this article]

The evidence for change

Barriers to change

How should we change our practice?

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