{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T22:28:09Z","timestamp":1765837689017,"version":"3.48.0"},"reference-count":24,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2020,7,2]],"date-time":"2020-07-02T00:00:00Z","timestamp":1593648000000},"content-version":"unspecified","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000659","name":"Research Trainees Coordinating Centre","doi-asserted-by":"publisher","award":["DRF-2018-11-ST2-066"],"award-info":[{"award-number":["DRF-2018-11-ST2-066"]}],"id":[{"id":"10.13039\/501100000659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["205039\/Z\/16\/Z"],"award-info":[{"award-number":["205039\/Z\/16\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["CS-2016-16-007"],"award-info":[{"award-number":["CS-2016-16-007"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["T32-AR-007465"],"award-info":[{"award-number":["T32-AR-007465"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,5,28]]},"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval is not required for this systematic-review. The results will be published in a peer-reviewed journal and any deviations from the protocol will be clearly documented in the published manuscript of the full systematic-review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42019121738.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-033662","type":"journal-article","created":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T02:02:39Z","timestamp":1593741759000},"page":"e033662","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Is there an association between long-term antibiotics for acne and subsequent infection sequelae and antimicrobial resistance? A systematic review protocol"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5509-4428","authenticated-orcid":false,"given":"Ketaki","family":"Bhate","sequence":"first","affiliation":[{"name":"Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4720-6738","authenticated-orcid":false,"given":"Liang-Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Barbieri","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cl\u00e9mence","family":"Leyrat","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Hopkins","sequence":"additional","affiliation":[{"name":"Public Health England, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Stabler","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine Faculty of Infectious and Tropical Diseases, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Shallcross","sequence":"additional","affiliation":[{"name":"Institute of Health Informatics, Faculty of Pop Health Sciences, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liam","family":"Smeeth","sequence":"additional","affiliation":[{"name":"Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nick A","family":"Francis","sequence":"additional","affiliation":[{"name":"School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3817-8790","authenticated-orcid":false,"given":"Rohini","family":"Mathur","sequence":"additional","affiliation":[{"name":"Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sin\u00e9ad M","family":"Langan","sequence":"additional","affiliation":[{"name":"Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah-Jo","family":"Sinnott","sequence":"additional","affiliation":[{"name":"Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,7,2]]},"reference":[{"key":"2025121514264977000_10.7.e033662.1","unstructured":"World Health Organization . Global action plan on antimicrobial resistance, 2015."},{"key":"2025121514264977000_10.7.e033662.2","unstructured":"O'Neill J . Tackling drug-resistant infections globally: final report and recommendations. The review on antimicrobial resistance, 2016."},{"key":"2025121514264977000_10.7.e033662.3","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12149"},{"key":"2025121514264977000_10.7.e033662.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60321-8"},{"key":"2025121514264977000_10.7.e033662.5","unstructured":"Whitehouse HJ FE , El\u2010Mansori I , Layton AM . Oral antibiotics for acne: are we adopting premium use? Presentation at the Annual Conference of the British Association of Dermatologists; 5\u20137 July, Birmingham, UK, 2016."},{"key":"2025121514264977000_10.7.e033662.6","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 treatment of acne among general practitioners (GP): a retrospective cohort study","volume":"75","author":"Barbieri","year":"2016","journal-title":"J Am Acad Dermatol"},{"key":"2025121514264977000_10.7.e033662.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2014.02.031"},{"key":"2025121514264977000_10.7.e033662.8","unstructured":"Whitehouse HJ , E-MIaLAM FE . Conference presentation: oral antibiotics for acne: are we adopting premium use? British association of dermatologists annual conference 2016, 2016."},{"key":"2025121514264977000_10.7.e033662.9","unstructured":"National Institute of Health and Care Excellence . Clinical knowledge summaries. 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