If potential complications and side effects of oral antibiotic therapy were minimized, the vast majority of rosacea sufferers would be more likely to accept oral therapy to treat their condition, according to results of a recent National Rosacea Society survey of 520 rosacea patients.
More than 85 percent of respondents said they would be more likely to accept oral antibiotics if side effects such as gastrointestinal upset and complications such as antibiotic resistance were reduced. Seventy-six percent reported that an oral antibiotic had at some time been prescribed to treat their rosacea, but only 31 percent said it was part of their current treatment regimen.
"Anti-bacterial doses of oral antibiotics have often been prescribed for rosacea, most commonly along with topical therapy to bring the disorder under rapid control, followed by long-term use of the topical medication alone to maintain remission," said Dr. David Cohen, associate professor of dermatology at New York University. "Their effectiveness, however, appears to be due to their anti-inflammatory properties rather than from destroying bacteria."
He noted that an anti-inflammatory, delayed-release version of oral doxycycline has recently been developed specifically for rosacea at a very low dose to avoid side effects or bacterial resistance, and has been found appropriate for long-term use.
In responding to the survey on oral antibiotics, 78 percent of the rosacea patients said they were concerned about side effects, while 66 percent said they were worried about developing antibiotic resistance. Thirty-one percent cited a concern about MRSA, a potentially life-threatening infection associated with antibiotic resistance, and 27 percent said allergies were an issue.
Sixty-seven percent of the patients named potential gastrointestinal upset as one of their concerns about oral antibiotics. Other potential side effects that were worrisome included phototoxicity (an extreme sensitivity to sunlight), cited by 55 percent; yeast infection, named by 51 percent; tooth discoloration, mentioned by 39 percent; and nausea, cited by 33 percent.
"Commitment to long-term medical therapy is one of the keys to keeping rosacea under control, so an oral medication that can treat the condition without the unwanted side effects or complications is an important addition," Dr. Cohen said. "Rosacea patients should work with their doctor to find the medication or combination of therapies that works best in their individual case."