Antibiotic resistance patterns in treatment-resistant Acne Vulgaris post-COVID-19: A study from Basrah, Iraq

Background: Acne is among the most common skin diseases. Bacteria contribute to inflammatory lesions in acne. By using antibiotics in the management, a problem is increasing resistance to these antibiotics. Aims: To evaluate the activity of some antibiotics against bacteria involved in acne vulgaris that were isolated from patients suffering from treatment-resistant acne vulgaris after COVID-19. Methods: The study included sixty-two patients with treatment-resistant pustules. Samples were collected from the patients using sterile swabs to culture them on culture media under aerobic and anaerobic conditions. All isolates were subjected to routine tests to identify bacterial species, and Antibacterial Sensitivity Tests were done to test twenty-seven antibacterial agents. Results: The main causative microbial agent was Staphylococcus epidermidis (90%), Staphylococcus aureus (8.4%), and (1.6%)for both Escherichia coli and Proteus. All isolates of S.epidermidis were completely resistant to some Macrolides, such as Azithromycin and Erythromycin and other beta-lactam antibiotics, such as Cefixime, Penicillins, and Amoxicillin. In contrast, most isolates resisted Clarithromycin, Cephoxitin, Doxycycline, Tetracycline and Gentamicin. Other isolates show sensitivity towards some antibiotics, including Cephotaxin, Amikacin, and Levofloxacin.Most isolates of S. aureus were resistant to Azthromycin, Clindamycin , Erythromycin but susceptible to Cephalothin and Cephoxitin. Conclusions: Bacteria causing acne vulgaris in this study were resistant to several antibiotics used in the treatment regimen but sensitive to other antibiotics not used for treatment, according to in vitro drug sensitivity testing. The antibiotics used for treatment should be reevaluated.