The pharmacology of antibiotic therapy in hidradenitis suppurativa

ABSTRACT

Introduction

Hidradenitis suppurativa (HS) is a chronic, inflammatory, and debilitating skin disease. Several pharmacologic agents have been described to reduce lesion activity and inflammation in HS. In this study, we have reviewed the available antibiotic therapies for HS, analyzing the pharmacologic aspects of these kind of treatments.

Areas covered

The role of bacteria, infections, and superinfections in HS is still debated and controversial. Antibiotics are recognized as first-line treatments for hidradenitis suppurativa, but the data on their efficacy are limited. Antibiotics should not be replaced by new biological therapies and it is not necessary to make an efficacy classification: it is important for dermatologists to recognize the right patient and the right moment to prescribe an antibiotic therapy, together or in a rotational way with other therapeutic options.

Expert opinion

The HS treatment process for the physicians is often complicated by the disease’s severity and several comorbidities. Fortunately, a better understanding of HS pathogenesis has been used to improve treatment strategies. Antibiotic therapy is an effective treatment of patients with HS but probably, in the next five years, many therapeutic options will be available, which will change the way we manage the disease, especially the moderate-to-severe forms of HS.

KEYWORDS:

• Antibiotics
• hidradenitis suppurativa
• pharmacology
• acne inversa
• therapies

Article highlights box

• Hidradenitis suppurativa (HS) is a chronic, inflammatory, and debilitating skin disease. Several pharmacologic agents have been described to reduce lesion activity and inflammation in HS.

• Available antibiotic therapies for HS, analyzing the pharmacologic aspects of these kind of treatments, have a key role in the management of this complex disease.

• The role of bacteria and infections and superinfections in HS is still debated and controversial.

• Antibiotics are recognized as first-line treatments for hidradenitis suppurativa, but the data on their efficacy are limited.

• A better understanding of HS pathogenesis has been used to improve treatment strategies. Antibiotic therapy is an effective treatment of patients with HS but probably, in the next 5 years, many therapeutic options will be available, which will change the management of HS.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

A reviewer on this manuscript has declared that they have received honoraria from AbbVie and Novartis as a consultant and provided lectures for AbbVie, Brothier, Cicaplus, Coloplast, Inresa, and Novartis. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.