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Bacteriology of hidradenitis suppurativa - which antibiotics are the treatment of choice?

The bacterial superinfection in hidradenitis suppurativa (HS), although it does not initiate the disease itself, seems to be one of the major contributors to an inflammatory vicious circle. Antibiotic therapy is therefore commonly prescribed in HS. This study was undertaken to evaluate the prescription of systemic antibiotics in the light of bacteriological cultures and antibiograms. The study was conducted on a group of 69 patients with HS. The huge majority (n=62) of the patients were treated with antibiotics. The antibiotics were prescribed 132 times and taken for a mean period of 9.9 ± 8.9 weeks. The most commonly used antibiotic was doxycycline (16.7%). The majority of the patients had a polymicrobial flora with up to 5 species, predominantly staphylococci and bacteria of intestinal flora. The highest effectiveness against isolates was observed for carbapanems, penicillins with β-lactamase inhibitors and fluoroquinolones - 8.5%, 11.9%, and 11.9% of resistant strains, respectively. In daily practice penicillins with β-lactamase inhibitors or fluoroquinolones could serve as first-line therapy of HS.