{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T18:14:00Z","timestamp":1782929640145,"version":"3.54.5"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,12,13]],"date-time":"2022-12-13T00:00:00Z","timestamp":1670889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIHR Doctoral Research Fellowship"},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100023699","name":"Health Data Research UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023699","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"UK Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000266","name":"Engineering and Physical Sciences Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000266","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000269","name":"Economic and Social Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000276","name":"Department of Health and Social Care","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000276","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100010756","name":"Health and Social Care Research and Development Division","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010756","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001626","name":"Public Health Agency","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001626","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"name":"European Union Horizon 2020-funded BIOMAP Consortium"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The inappropriate use of antibiotics is understood to contribute to antimicrobial resistance. Oral antibiotics are regularly used to treat moderate-to-severe acne vulgaris. In practice, we do not know the typical length of oral antibiotic treatment courses for acne in routine primary care and what proportion of people receive more than one course of treatment following a new acne diagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To describe how oral antibiotics are prescribed for acne over time in UK primary care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a descriptive longitudinal drug utilization study using routinely collected primary care data from the Clinical Practice Research Datalink GOLD (2004\u20132019). We included individuals (8\u201350\u2005years) with a new acne diagnosis recorded between 1 January 2004 and 31 July 2019.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 217 410 people with a new acne diagnosis. The median age was 17\u2005years [interquartile range (IQR) 15\u201325] and median follow-up was 4.3\u2005years (IQR 1.9\u20137.6). Among people with a new acne diagnosis, 96 703 (44.5%) received 248 560 prescriptions for long-term oral antibiotics during a median follow-up of 5.3\u2005years (IQR 2.8\u20138.5). The median number of continuous courses of antibiotic therapy (\u2265 28\u2005days) per person was four (IQR 2\u20136). The majority (n = 59 010, 61.0%) of first oral antibiotic prescriptions in those with a recorded acne diagnosis were between the ages of 12 and 18. Most (n = 71 544, 74.0%) first courses for oral antibiotics were for between 28 and 90\u2005days. The median duration of the first course of treatment was 56\u2005days (IQR 50\u201393\u2005days) and 18 127 (18.7%) of prescriptions of \u2265 28\u2005days were for &amp;lt; 6 weeks. Among people who received a first course of oral antibiotic for \u2265 28\u2005days, 56 261 (58.2%) received a second course after a treatment gap of \u2265 28\u2005days. The median time between first and second courses was 135\u2005days (IQR 67\u2013302). The cumulative duration of exposure to oral antibiotics during follow-up was 255\u2005days (8.5\u2005months).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Further work is needed to understand the consequences of using antibiotics for shorter periods than recommended. Suboptimal treatment duration may result in reduced clinical effectiveness or repeated exposures, potentially contributing to antimicrobial resistance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjd\/ljac084","type":"journal-article","created":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T14:20:53Z","timestamp":1674224453000},"page":"361-371","source":"Crossref","is-referenced-by-count":11,"title":["Long-term oral antibiotic use in people with acne vulgaris in UK primary care: a drug utilization study"],"prefix":"10.1093","volume":"188","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5509-4428","authenticated-orcid":false,"given":"Ketaki","family":"Bhate","sequence":"first","affiliation":[{"name":"Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn E","family":"Mansfield","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7586-686X","authenticated-orcid":false,"given":"Sarah-Jo","family":"Sinnott","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0506-8085","authenticated-orcid":false,"given":"David J","family":"Margolis","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Department of Biostatistics and Epidemiology, University of Pennsylvania , Philadelphia, PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth\u00a0","family":"Adesanya","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8939-7312","authenticated-orcid":false,"given":"Nick","family":"Francis","sequence":"additional","affiliation":[{"name":"School of Primary Care, Population Sciences and Medical Education, University of Southampton , Southampton , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4097-4577","authenticated-orcid":false,"given":"Clemence","family":"Leyrat","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5179-5702","authenticated-orcid":false,"given":"Susan","family":"Hopkins","sequence":"additional","affiliation":[{"name":"UK Health Security Agency , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2402-6630","authenticated-orcid":false,"given":"Richard","family":"Stabler","sequence":"additional","affiliation":[{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1713-2555","authenticated-orcid":false,"given":"Laura","family":"Shallcross","sequence":"additional","affiliation":[{"name":"Faculty of Population Health Sciences, University College London , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7022-7441","authenticated-orcid":false,"given":"Sin\u00e9ad M","family":"Langan","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3817-8790","authenticated-orcid":false,"given":"Rohini","family":"Mathur","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,12,13]]},"reference":[{"key":"2023100620083176400_ljac084-B1","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1111\/bjd.12149","article-title":"Epidemiology of acne vulgaris","volume":"168","author":"Bhate","year":"2013","journal-title":"Br J Dermatol"},{"key":"2023100620083176400_ljac084-B2","author":"Whitehouse"},{"key":"2023100620083176400_ljac084-B3","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1016\/j.jaad.2016.06.057","article-title":"Duration of oral tetracycline-class antibiotic therapy and use of topical retinoids for the 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