Antibiotic resistance to Propionobacterium acnes: worldwide scenario, diagnosis and management

Expert Rev Anti Infect Ther. 2015 Jul;13(7):883-96. doi: 10.1586/14787210.2015.1040765. Epub 2015 May 29.


Antibiotic resistance in cutaneous Propionobacterium is a global problem. As a general rule, resistance levels are high to macrolides, trimethoprim/sulfamethoxazole and clindamycin, while tetracyclines and levofloxacin have low resistance potential. Newer preparations like doxycycline MR and doxycycline 20 mg are subantimicrobial and may not lead to resistance. Sampling techniques are crucial to determine resistance. Genomic evaluation using 16S ribosomal RNA gene sequencing can be useful in diagnosing mutations and mapping phylotypes of Propionobacterium acnes. Resistance may lead to slow response and relapses. Apart from benzoyl peroxide, azelaic acid, topical dapsone, oral zinc and retinoids, novel molecules with little resistance potential include octadecenedioic acid, phytosphingosine, lauric acid, retapamulin, resveratrol, T-3912 and NB-003. The use of oral retinoids and non-antibiotics like zinc can prevent resistance and help reduce the dependence on antibiotics.

Keywords: 16S RNA PCR; BPO; NB-003; T-3912; acne; azelaic acid; biofilms; clindamycin; lauric acid; levofloxacin; macrolides; resistance; resveratrol; retapamulin.

Publication types

  • Review

MeSH terms

  • Acne Vulgaris / drug therapy
  • Acne Vulgaris / epidemiology*
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Disease Management
  • Drug Resistance, Microbial / drug effects*
  • Drug Resistance, Microbial / physiology
  • Global Health* / trends
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / epidemiology*
  • Humans
  • Propionibacterium acnes / drug effects*
  • Propionibacterium acnes / physiology


  • Anti-Bacterial Agents