P049 Improving care for patients with acne vulgaris: an audit of oral lymecycline therapy against the NICE guidelines (NG198)

Abstract Acne vulgaris, a multifactorial and persistent condition, affects an estimated 9% of the population worldwide, with significant prevalence among adolescents and adults. Managing acne poses challenges in ensuring adherence to established guidelines while addressing rising antimicrobial resistance. The Cutibacterium acnes resistance crisis underscores the importance of optimized prescribing practices. This audit is the first to comprehensively evaluate adherence to the National Institute for Health and Care Excellence (NICE) NG198 guidelines for oral lymecycline therapy. The audit was performed in a high-volume primary care setting with a patient population of over 15 000, marking a significant advancement in understanding compliance gaps. The aim was to assess oral lymecycline prescribing practices for acne vulgaris, focusing on adherence to the NICE NG198 guidelines. The audit evaluated prescribing combination therapy, treatment durations, and avoidance of concurrent antibiotic use, aiming to identify gaps and propose solutions for improvement. A retrospective review was conducted over 6 months in a primary care setting. Patients prescribed oral lymecycline for acne vulgaris were included, while those with alternative diagnoses were excluded. Data on co-prescription of topical treatments, treatment durations and patterns of antibiotic use were collected and analysed to provide a comprehensive overview of guideline adherence. Overall, 22% of the population sampled adhered fully to the NICE guidelines, including the co-prescription of oral lymecycline with a recommended topical agent for a maximum of 12 weeks, followed by reassessment. One-half (54%) of patients received a topical treatment, with benzoyl peroxide and adapalene (Epiduo®) being the most common combination. In total, 13% of patients were prescribed concurrent oral and topical antibiotics, contrary to guidelines. Continuous treatment durations ranged from 1 month to 7.5 years, with a median duration of 4 months. Demographic analysis showed a predominance of female patients (63%), with a median age of 17 years. In conclusions, this audit highlights critical gaps in prescribing practices, underscoring the need for systemic improvements to align with NICE guidelines. Interventions such as clinician education, the integration of NICE guidance into clinical systems, and structured treatment reviews are recommended to address these issues.