{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T12:51:14Z","timestamp":1784206274995,"version":"3.55.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Systemic antibiotics for moderate-to-severe acne are commonly prescribed, but the optimal duration remains unclear. Prolonged use may increase recurrence rates and antibiotic resistance. This study evaluated the long-term effects of antibiotic duration on acne recurrence and microbial resistance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study included a single-center retrospective cohort of 240 patients (12\u201340\u202fyears) with moderate-to-severe acne treated with doxycycline or minocycline (2020\u20132023). Patients were stratified into groups by duration: short-term (6\u201312\u202fweeks,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f80), standard-term (13\u201316\u202fweeks,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f80), and prolonged (17\u201324 weeks,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f80) groups. The primary outcome was the 12-month recurrence rate. Secondary outcomes included 12-week treatment success, scarring, adverse reactions, and resistance development (culture subset,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f46).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 12-month recurrence rates increased in a duration-dependent manner: 23.8% (short-term duration), 35.0% (standard-term duration), and 46.3% (prolonged duration) (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). The median recurrence-free survival was 9.2, 8.1, and 6.9\u202fmonths, respectively (log-rank\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Prolonged exposure independently predicted recurrence (adjusted hazard ratio (HR): 2.31, 95%CI 1.31\u20134.07,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.004). The 12-week success rates were similar (73.8\u201376.3%, P=0.78). Scarring (21.3\u201322.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.97) and adverse events (27.5\u201331.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.83) did not differ. Tetracycline resistance was more frequent with prolonged exposure (42.9% vs. 13.3\u201317.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.032).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Extended antibiotic therapy for acne was associated with an increased 12-month recurrence risk without improving short-term outcomes, consistent with guideline recommendations to limit duration and emphasize antimicrobial stewardship.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1782651","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T05:51:14Z","timestamp":1775022674000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Long-term impact of antibiotic exposure duration on recurrence and microbial resistance in moderate-to-severe acne: a real-world retrospective analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Li","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Dermatology, Shanghai Seventh People's Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Emergency Surgery, Gongli Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Shanghai Seventh People's Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luying","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Shanghai Seventh People's Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Shanghai Seventh People's Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Shanghai Seventh People's Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","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":"ref2","first-page":"S163","article-title":"Evidence-based recommendations for the diagnosis and treatment of pediatric 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