PracticeUpdate Conference Series: IID 2018

lesions. Few data, however, support the use of antiseptic washes, both to manage hidradenitis suppurativa and to prevent antibiotic resistance.” “Our aim,” she asserted, “in conducting this study was to better understand the role that antiseptic washes may play in mitigating antibiotic resistance.” The team assessed patients with hidrad- enitis suppurativa at two tertiary care centers from 2012–2017. They abstracted data from the electronic records of 80 patients with a total of 121 total wound or tissue culture specimens from hidradenitis suppurativa lesions. The study included culture results and the use of oral or top- ical antibiotics and antiseptic cleansers such as chlorhexidine, dilute bleach baths, and benzoyl peroxide concomitantly or within 4 weeks prior to culture. Dr. Sciacca Kirby told Elsevier’s PracticeUpdate , “While topical antimicro- bial washes are frequently discussed for hidradenitis suppurativa, this study found they were part of the treatment plan in about 38% of patients.” Staphylococcus aureus was the most common bacterium cultured from

Lower resistance rates to penicillins were observed in patients not using antibiotics or concomitant antiseptic wash vs penicil- lins + a concomitant antiseptic wash (no antibiotics/antiseptics 37.7% vs penicillins + antiseptic cleanser 51.8%, P = .02). Ms. Ma, Mr. Leiphart, andDrs. Sciacca Kirby and Naik concluded that taking antibiot- ics may contribute to antibiotic-resistant organisms in hidradenitis suppurativa lesions. Further study is needed to deter- mine whether antiseptic washes affect resistance rates and their role in the management of hidradenitis suppurativa. Dr. Naik noted, “Results of this small ret- rospective study are compelling because they indicate that prolonged and likely repetitive courses of antibiotics for hidradenitis suppurativa management may contribute to antibiotic resistance. They also suggest a possible role of anti- septics in mitigating resistance to specific antibiotics used to manage the disorder. Antiseptics may potentially ensure anti- biotic efficacy. Large prospective studies are needed to confirm and expand our findings.”

hidradenitis suppurativa lesions. It exhib- ited lower resistance rates to tetracyclines (15.9%) and trimethoprim-sulfamethoxa- zole (4.4%) and higher resistance rates to penicillins (61.6%) and cephalosporins (35.3%) (P < .0001). Across cultures, the resistance rate for penicillins (43.1%) was the highest of all cultures and sensitivities performed. Clindamycin, tetracyclines, and cephalo- sporins all exhibited resistance rates of 13% or higher. The researchers investigated whether rates of resistance to these antibiotics differed when patients were treated with an antibiotic alone, an antibiotic + an anti- septic wash, an antiseptic wash alone, or none of these. The team found a difference in rates of resistance across groups to penicillins and cephalosporins (P = .02). Specifically, cephalosporin resistance was lower in patients who used antibiotics + a con- comitant antiseptic wash (4 of 44 patients, 9.1%); the wash alone (1 of 15 patients, 6.7%); or neither (5 of 60 patients, 8.3%); than in those using an antibiotic alone (9 of 27 patients, 33.3%).

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IID 2018 • PRACTICEUPDATE CONFERENCE SERIES