AT SDEF LAS VEGAS DERMATOLOGY SEMINAR
LAS VEGAS – Coprescribing isotretinoin and tetracycline antibiotics among dermatologists and nondermatologists was low, according to a study that analyzed 11 years of ambulatory medical data.
The findings were presented in a poster at the Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
“Patients with an inadequate response to tetracyclines or severe cases of acne may require isotretinoin,” wrote Brooke Vasicek, MD, of Loyola University Chicago in Maywood, Ill., and colleagues. However, since the combined use of tetracyclines and isotretinoin puts patients at risk of pseudotumor cerebri, which may lead to blindness, “concurrent use of these medications must be avoided,” they explained.
To assess the frequency of isotretinoin/tetracycline coprescribing, they reviewed data from the National Ambulatory Medical Care Survey collected during 2003-2013 and estimated the number of prescriptions for isotretinoin and/or tetracycline. The dataset included 51,980,042 visits to dermatologists for acne and 29,063,717 visits to nondermatologists.
Of the dermatologists in the survey data, 13.6% reported prescribing isotretinoin (compared with 1.6% of nondermatologists), 29.2% reported prescribing tetracycline (compared with 22.9% of nondermatologists), and 0.40% reported concurrently prescribing both medications (compared with .025% of nondermatologists).
Dermatologists were significantly more likely to mention isotretinoin than nondermatologists, but mention of tetracycline was not significantly different among specialties. “Acne severity and level of comfort because of specialty-based training may be at play in the isotretinoin prescribing pattern differences between dermatologists and nondermatologists,” the researchers noted. The increased pseudotumor cerebri risk associated with combining the medications “is well known among dermatologists, hence, patient exposure is likely very uncommon,” they added.
The results were limited by the cross-sectional nature of the study and possible sampling bias associated with the data collection source, they said.
The researchers had no financial conflicts to disclose.
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