Clindamycin Mono-Therapy of Hidradenitis Suppurativa Patients: A Single-Center Retrospective Study
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Background: A rifampicin (RF)-clindamycin (CL) combination therapy is recommended as the first-line treatment for moderate to severe hidradenitis suppurativa (HS). Although the long-term use of RF requires caution due to the possibility of developing resistant bacteria, only a few studies have investigated alternatives for this combination therapy. Objective: To evaluate the efficacy of systemic CL mono-therapy and assess the prevalence and CL resistance of bacterial growth in HS patients. Methods: A total of 53 HS patients treated with CL mono-therapy were included. The efficacy was evaluated by identifying the rate of HS Clinical Response (Hi-SCR) achievers and com- paring HS Physician’s Global Assessment (HS-PGA) before (W0) and after (W8) the treat- ment. Purulent material from HS skin lesions was collected on the W0. Bacterial flora and antibiotic sensitivity were determined by bacterial cultures. Results: Of 53 HS patients, 34 were eligible for evaluation of the efficacy of the therapy. Twen- ty-one patients (61.76%) achieved Hi-SCR. The mean scoring of HS-PGA had significantly decreased from 3.24 to 2.15 ( =0.001). The prevalence of CL resistance was 15.00%. No sig- nificant differences in the efficacy of the therapy according to the presence of CL-resistant bacteria on the W0 were observed ( =0.906). Adverse events occurred in 26.42% of patients. Conclusion: Systemic CL mono-therapy may be a safe and useful alternative to RF-CL com- bination therapy, and no significant difference in the efficacy of the therapy depending on the presence of CL-resistant bacteria was observed.
Abstract
Background: A rifampicin (RF)-clindamycin (CL) combination therapy is recommended as the first-line treatment for moderate to severe hidradenitis suppurativa (HS). Although the long-term use of RF requires caution due to the possibility of developing resistant bacteria, only a few studies have investigated alternatives for this combination therapy. Objective: To evaluate the efficacy of systemic CL mono-therapy and assess the prevalence and CL resistance of bacterial growth in HS patients. Methods: A total of 53 HS patients treated with CL mono-therapy were included. The efficacy was evaluated by identifying the rate of HS Clinical Response (Hi-SCR) achievers and com- paring HS Physician’s Global Assessment (HS-PGA) before (W0) and after (W8) the treat- ment. Purulent material from HS skin lesions was collected on the W0. Bacterial flora and antibiotic sensitivity were determined by bacterial cultures. Results: Of 53 HS patients, 34 were eligible for evaluation of the efficacy of the therapy. Twen- ty-one patients (61.76%) achieved Hi-SCR. The mean scoring of HS-PGA had significantly decreased from 3.24 to 2.15 ( =0.001). The prevalence of CL resistance was 15.00%. No sig- nificant differences in the efficacy of the therapy according to the presence of CL-resistant bacteria on the W0 were observed ( =0.906). Adverse events occurred in 26.42% of patients. Conclusion: Systemic CL mono-therapy may be a safe and useful alternative to RF-CL com- bination therapy, and no significant difference in the efficacy of the therapy depending on the presence of CL-resistant bacteria was observed.
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