Which medications in the drug class Antibiotics, Other are used in the treatment of Hidradenitis Suppurativa?

Updated: Aug 30, 2019
  • Author: Marina Jovanovic, MD, PhD; Chief Editor: William D James, MD  more...
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Answer

Antibiotics, Other

Acute episodes and relapses of hidradenitis suppurativa should be treated as bacterial infections.

Tetracycline

Tetracycline is used to treat gram-positive and gram-negative organisms and mycoplasmal, chlamydial, and rickettsial infections. It inhibits bacterial protein synthesis by binding with 30S and possibly 50S ribosomal subunits. It can be prolonged if clinically indicated.

Doxycycline (Doryx, Vibramycin, Adoxa)

Doxycycline inhibits protein synthesis and thus bacterial growth by binding to 30S and possibly 50S ribosomal subunits of susceptible bacteria.

Clindamycin (Cleocin)

Clindamycin is a lincosamide for the treatment of serious skin and soft tissue staphylococcal infections. It is also effective against aerobic and anaerobic streptococci (except enterococci). It inhibits bacterial growth, possibly by blocking the dissociation of peptidyl t-RNA from ribosomes, causing RNA-dependent protein synthesis to arrest.

Rifampin (Rifadin, Rimactane)

Rifampin inhibits DNA-dependent RNA polymerase activity in bacteria, by interacting with bacterial RNA polymerase.

Erythromycin (E.E.S., Ery-Tab, Erythrocin)

Erythromycin inhibits bacterial growth, possibly by blocking dissociation of peptidyl t-RNA from ribosomes, causing RNA-dependent protein synthesis to arrest. In children, age, weight, and the severity of infection determine the proper dosage. When twice-daily dosing is desired, half the total daily dose may be taken every 12 hours. For more severe infections, double the dose.

Dapsone

Dapsone is bactericidal and bacteriostatic against mycobacteria; its mechanism of action similar to that of sulfonamides, in which competitive antagonism of PABA prevents the formation of folic acid, inhibiting bacterial growth. Dapsone therapy with 25-200 mg/day should be initiated if standard first- or second-line agents fail. There are no data on maximum duration of therapy (reported range, 3-48 months).

Minocycline (Minocin, Solodyn)

Minocycline can be used for the treatment of infections caused by susceptible gram-negative and gram-positive organisms, in addition to infections caused by susceptible rickettsial, chlamydial, and mycoplasmal organisms.

Trimethoprim/sulfamethoxazole (Bactrim, Bactrim DS, Septra DS, Sulfatrim)

This combination agent inhibits bacterial growth by inhibiting the synthesis of dihydrofolic acid. The antibacterial activity of TMP-SMZ includes common urinary tract pathogens, except Pseudomonas aeruginosa.


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