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Is there an association between long-term antibiotics for acne and subsequent infection sequelae and antimicrobial resistance?: A systematic review protocol

Is there an association between long-term antibiotics for acne and subsequent infection sequelae and antimicrobial resistance?: A systematic review protocol
Is there an association between long-term antibiotics for acne and subsequent infection sequelae and antimicrobial resistance?: A systematic review protocol
Introduction: Antimicrobial resistance (AMR) is a global health emergency. Acne vulgaris is a highly prevalent condition and the dominant role antibiotics play in its treatment is a major concern. Antibiotics are widely used in the treatment of acne predominantly for their anti-inflammatory effect, hence their use in acne may not be optimal. Tetracyclines and macrolides are the two most common oral antibiotic classes prescribed, and their average use can extend from a few months to several years of intermittent or continuous use. The overall aim of this systematic review is to elucidate what is known about oral antibiotics for acne contributing to antibiotic treatment failure and AMR.

Methods and analysis: A systematic review will be conducted to address the question: What is the existing evidence that long-term oral antibiotics used to treat acne in those over 8 years of age contribute towards antibiotic treatment failure or other outcomes suggestive of the impact of AMR? We will search the following databases: Embase, MEDLINE, the Cochrane Library and Web of Science. Search terms will be developed in collaboration with a librarian by identifying keywords from relevant articles and by undertaking pilot searches. Randomised controlled trials, cohort and case-controlled studies conducted in any healthcare setting and published in any language will be included. The searches will be re-run prior to final analyses to capture the recent literature. The Cochrane tool for bias assessment in randomised trials and ROBINS-I for the assessment of bias in non-randomised studies will be used to assess the risk of bias of included studies. GRADE will be used to make an overall assessment of the quality of evidence. A meta-analysis will be undertaken of the outcome measures if the individual studies are sufficiently homogeneous. If a meta-analysis is not possible, a qualitative assessment will be presented as a narrative review.
acne, antimicrobial resistance, dermatological epidemiology, epidemiology
2044-6055
e033662
Bhate, Ketaki
3354fba9-7bcb-4d30-bee0-d831686bc6bc
Lin, Liang-Yu
805cb19d-a7ff-4ae5-b0f7-96384ea45c30
Barbieri, John
b0cbe810-8112-4cb8-99a8-259e040a56c1
Leyrat, Clémence
9378b420-4272-4739-8736-17e59b982272
Hopkins, Susan
b029cd66-2cdd-469b-9404-90294a360ec9
Stabler, Richard
a4d56a2d-12f2-44cc-9a8a-c5938a4a1030
Shallcross, Laura
e9e609c8-8179-437b-a12d-5a5b23763a84
Smeeth, Liam
bf63d51e-40ce-4918-b5bc-0b365f49b677
Francis, Nick A
9b610883-605c-4fee-871d-defaa86ccf8e
Mathur, Rohini
989febb1-9d36-4ce0-8690-3b163a385dd3
Langan, Sinéad M
d60ad92d-9bac-44fa-bbd8-6b3245eaa687
Sinnott, Sarah-Jo
085e9059-b4ee-4d70-8abc-9a0fd903e976
Bhate, Ketaki
3354fba9-7bcb-4d30-bee0-d831686bc6bc
Lin, Liang-Yu
805cb19d-a7ff-4ae5-b0f7-96384ea45c30
Barbieri, John
b0cbe810-8112-4cb8-99a8-259e040a56c1
Leyrat, Clémence
9378b420-4272-4739-8736-17e59b982272
Hopkins, Susan
b029cd66-2cdd-469b-9404-90294a360ec9
Stabler, Richard
a4d56a2d-12f2-44cc-9a8a-c5938a4a1030
Shallcross, Laura
e9e609c8-8179-437b-a12d-5a5b23763a84
Smeeth, Liam
bf63d51e-40ce-4918-b5bc-0b365f49b677
Francis, Nick A
9b610883-605c-4fee-871d-defaa86ccf8e
Mathur, Rohini
989febb1-9d36-4ce0-8690-3b163a385dd3
Langan, Sinéad M
d60ad92d-9bac-44fa-bbd8-6b3245eaa687
Sinnott, Sarah-Jo
085e9059-b4ee-4d70-8abc-9a0fd903e976

Bhate, Ketaki, Lin, Liang-Yu, Barbieri, John, Leyrat, Clémence, Hopkins, Susan, Stabler, Richard, Shallcross, Laura, Smeeth, Liam, Francis, Nick A, Mathur, Rohini, Langan, Sinéad M and Sinnott, Sarah-Jo (2020) Is there an association between long-term antibiotics for acne and subsequent infection sequelae and antimicrobial resistance?: A systematic review protocol. BMJ Open, 10 (7), e033662, [e033662]. (doi:10.1136/bmjopen-2019-033662).

Record type: Article

Abstract

Introduction: Antimicrobial resistance (AMR) is a global health emergency. Acne vulgaris is a highly prevalent condition and the dominant role antibiotics play in its treatment is a major concern. Antibiotics are widely used in the treatment of acne predominantly for their anti-inflammatory effect, hence their use in acne may not be optimal. Tetracyclines and macrolides are the two most common oral antibiotic classes prescribed, and their average use can extend from a few months to several years of intermittent or continuous use. The overall aim of this systematic review is to elucidate what is known about oral antibiotics for acne contributing to antibiotic treatment failure and AMR.

Methods and analysis: A systematic review will be conducted to address the question: What is the existing evidence that long-term oral antibiotics used to treat acne in those over 8 years of age contribute towards antibiotic treatment failure or other outcomes suggestive of the impact of AMR? We will search the following databases: Embase, MEDLINE, the Cochrane Library and Web of Science. Search terms will be developed in collaboration with a librarian by identifying keywords from relevant articles and by undertaking pilot searches. Randomised controlled trials, cohort and case-controlled studies conducted in any healthcare setting and published in any language will be included. The searches will be re-run prior to final analyses to capture the recent literature. The Cochrane tool for bias assessment in randomised trials and ROBINS-I for the assessment of bias in non-randomised studies will be used to assess the risk of bias of included studies. GRADE will be used to make an overall assessment of the quality of evidence. A meta-analysis will be undertaken of the outcome measures if the individual studies are sufficiently homogeneous. If a meta-analysis is not possible, a qualitative assessment will be presented as a narrative review.

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More information

Accepted/In Press date: 28 May 2020
e-pub ahead of print date: 2 July 2020
Published date: 2 July 2020
Additional Information: © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.
Keywords: acne, antimicrobial resistance, dermatological epidemiology, epidemiology

Identifiers

Local EPrints ID: 444608
URI: http://eprints.soton.ac.uk/id/eprint/444608
ISSN: 2044-6055
PURE UUID: 4cacd603-a7ab-4ced-80f0-6e6f738ea33d
ORCID for Nick A Francis: ORCID iD orcid.org/0000-0001-8939-7312

Catalogue record

Date deposited: 27 Oct 2020 19:55
Last modified: 02 Sep 2022 01:59

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Contributors

Author: Ketaki Bhate
Author: Liang-Yu Lin
Author: John Barbieri
Author: Clémence Leyrat
Author: Susan Hopkins
Author: Richard Stabler
Author: Laura Shallcross
Author: Liam Smeeth
Author: Nick A Francis ORCID iD
Author: Rohini Mathur
Author: Sinéad M Langan
Author: Sarah-Jo Sinnott

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