Antibiotic treatment of acne may be associated with upper respiratory tract infections

Arch Dermatol. 2005 Sep;141(9):1132-6. doi: 10.1001/archderm.141.9.1132.


Objective: To determine if the long-term use of antibiotics for the treatment of acne results in an increase in either of 2 common infectious illnesses: upper respiratory tract infections (URTIs) or urinary tract infections.

Design: Retrospective cohort study.

Setting: General Practice Research Database of the United Kingdom, London, England, from 1987 to 2002.

Patients: Patients with a diagnosis of acne.

Main outcome measure: The onset of either a URTI or a urinary tract infection.

Results: Of 118 496 individuals with acne (age range, 15-35 years) who were identified in the General Practice Research Database, 84 977 (71.7%) received a topical or oral antibiotic (tetracyclines, erythromycin, or clindamycin) for treatment of their acne and 33 519 (28.3%) did not. Within the first year of observation, 18 281 (15.4%) of the patients with acne had at least 1 URTI, and within that year, the odds of a URTI developing among those receiving antibiotic treatment were 2.15 (95% confidence interval, 2.05-2.23; P<.001) times greater than among those who were not receiving antibiotic treatment. Multiple additional analyses, which were conducted to show that this effect was not an artifact of increased health care-seeking behavior among our cohorts, included comparing the cohorts of patients with acne with a cohort of patients with hypertension and the likelihood of developing a urinary tract infection.

Conclusions: Patients with acne who were receiving antibiotic treatment for acne were more likely to develop a URTI than those with acne who were not receiving such treatment. The true clinical importance of our findings will require further investigation.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acne Vulgaris / complications
  • Acne Vulgaris / drug therapy*
  • Adolescent
  • Adult
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use*
  • Causality
  • Female
  • Humans
  • Male
  • Respiratory Tract Infections / complications*
  • Risk Factors
  • Urinary Tract Infections / complications


  • Anti-Bacterial Agents