Evidence map›Paper›PMID 37603402›Full record

ArticleJMIR dermatology2023

Prescribing Patterns of Oral Antibiotics and Isotretinoin for Acne in a Colorado Hospital System: Retrospective Cohort Study.

Madeline J Adelman, Torunn E Sivesind, Isaac Weber, Grace Bosma, Camille Hochheimer, Chante Karimkhani, Lisa M Schilling, John S Barbieri, Robert P Dellavalle

Abstract read
In one paragraph

Article in JMIR dermatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Madeline J Adelman *Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, MI, United States.ORCID https://orcid.org/0000-0002-7816-8220
Torunn E Sivesind *Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, MI, United States.ORCID https://orcid.org/0000-0003-4805-0632
Isaac Weber *School of Medicine, University of Missouri, Columbia, MO, United States.ORCID https://orcid.org/0000-0002-4274-4708
Grace BosmaDepartment of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora, CO, United States.ORCID https://orcid.org/0000-0002-2397-2772
Camille HochheimerDepartment of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora, CO, United States.ORCID https://orcid.org/0000-0002-0984-0909
Chante KarimkhaniFlatirons Dermatology, Broomfield, CO, United States.ORCID https://orcid.org/0000-0003-2347-7576
Lisa M SchillingDepartment of Medicine and Division of General Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.ORCID https://orcid.org/0000-0002-6878-189X
John S BarbieriDepartment of Dermatology, Brigham and Women's Hospital, Boston, MA, United States.ORCID https://orcid.org/0000-0002-5467-4102
Robert P DellavalleDepartment of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, MI, United States.ORCID https://orcid.org/0000-0001-8132-088X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGuidelines established by the American Academy of Dermatology recommend oral antibiotics as first-line therapy for mild, moderate, and severe acne. However, it is recommended to minimize the duration of oral antibiotic use, and there is increasing support for other systemic agents for acne.

objectiveWe sought to characterize the use of oral antibiotics and isotretinoin for the treatment of acne in the pediatric and young adult population aged 10 through 20 years and the adult population aged 21 to 45 years from 2011 to 2019.

methodsWe conducted a retrospective, observational cohort study using electronic data from the enterprise data warehouse of the University of Colorado Anschutz Medical Campus and its affiliates, with data in the format of the Observational Health Data Sciences and Informatics (OHDSI) Observational Medical Outcomes Partnership (OMOP) common data model. Categorical values (sex, race, and ethnicity) were compared using chi-square tests, and continuous variables (age) were compared using 2-tailed t tests.

resultsOur cohort of 15,704 patients was composed of mostly White (12,776/15,704, 81.4%), non-Hispanic or Latino (13,307/15,704, 84.7%), and female (11,093/15,704, 70.6%) patients. Among the 4605 male patients in the eligible cohort, 1810 (39%) received an oral antibiotic treatment, in comparison to 3109 (28%) of the 11,093 eligible women (P<.001). Among the 4605 men who were eligible for treatment with isotretinoin in this population, 988 (21.5%) received a course of isotretinoin, compared to only 10.4% (1159/11,093) eligible women (P<.001). Male patients were 1.67 times more likely to have received an antibiotic prescription (odds ratio [OR] 1.67, 95% CI 1.55-1.79) and over twice as likely to have received an isotretinoin prescription (OR 2.34, 95% CI 2.13-2.57) than female patients.

conclusionsMinocycline was the most frequently prescribed antibiotic for the treatment of acne in this study cohort. From 2015 to 2019, there was no significant change in the number of antibiotic prescriptions over time. Men were significantly more likely to receive both oral antibiotics and isotretinoin than female patients. Multiple factors could be contributing to this discrepancy, including the burden of iPLEDGE, additional systemic treatment options for female patients, and the difference in acne severity across sexes. We could not determine the difference in severity of acne between male and female patients in our cohort, and further research is needed to ascertain the variation across sexes.

Indexed as

acneantibioticsdatabasesguidelinesisotretinoinprescribingretinoids

Identifiers

PMID37603402
PMCPMC10477922

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.