A New Antibiotic for Acne?
Dermatologists are always looking for new antibiotics for acne. Due to a phenomenon known as antibiotic resistance, fewer and fewer people benefit from old antibiotics and new medications are constantly sought. A antibiotic known as nadifloxacin is the latest addition to the armory of antibiotics that fight acne.
What is Nadifloxacin?
Nadifloxacin is the generic form of a fluoroquinolone antibiotic that has been available for several years under brand names such as Acuatim, Nadiflox, Nadoxin, Nadixa, and activon. Like all fluroquinolone antibiotics, it works by interfering with the ability of the bacterium to “unwind” its DNA. If the germ cannot transform DNA from a helix into a “rope,” then it cannot copy DNA to reproduce. Antibiotics in this class do not kill bacteria. They just keep them from reproducing.
Until recently, the primary use of nadifloxacin was treating an especially aggressive skin infection known as methicillin-resistant Staphylococcus aureus, or MRSA. This sometimes-deadly infection had developed resistance to other antibiotics, but not to nadifloxacin. Not only did nadifloxacin work, it has a half-life of 19 hours, so it only has to be used once a day, and it can be applied to directly to the skin in the form of a cream.
Some Doctors Don’t Think Nadofloxacin Should Be Used to Treat Acne
Doctors in India have been testing nadifloxacin as a replacement for clindamycin in treating acne. The problem with clindamycin in India has been that some strains of acne bacteria have developed resistance to it, so a new antibiotic will be needed. There is concern elsewhere in the world that using massive amounts of nadifloxacin to treat acne will make it ineffective against the much more dangerous MRSA. Let’s take a moment to explain how that works.
Billions of bacteria may live in a single drop of fluid on the skin. Ultraviolet light, infinitesimal amounts of chemicals, or glitches in antibiotic treatment may change the DNA in about one in a million or one in ten million of these bacteria at any given time.
Usually, random modification of DNA kills a bacterium, but once in a while the mutation of DNA gives the individual bacterium a way to resist an antibiotic. In the case of nadifloxacin, some mutation in the DNA might enable it to uncoil so the bacterium can reproduce itself even in the presence of the drug. If nothing else kills this bacterium, it passes its new gene down to its progeny, one at a time.
Bacteria, however, have the ability to conjugate, to swap genetic material when they collide with each other. While a bacterium could pass the new gene for antibiotic resistance to just one of its “children” at a time, it can pass copies of the gene to hundreds or thousands or its “conjugation partners.” Eventually so many of the bacteria that have the new antibiotic resistance gene occur on one patch of skin that the antibiotic can’t treat the infection any more.
Billions of people who have acne each have billions of bacteria in their pores. Eventually someone is going to have so many resistant bacteria that a treatment won’t work. That’s why dermatologists keep looking for new antibiotics. It’s also why dermatologists fear that using nadifloxacin for acne will eventually make it useless for treating MRSA (since some people who have both acne and MRSA infections that are not active enough to recognize will be using nadifloxacin to treat acne). But does nadifloxacin for acne really even work?
Effectiveness of Nadifloxacin in Treating Acne
If the question is whether nadifloxacin used by itself will clear up your acne, the answer is no. Clindamycin won’t, either. Doctors typically prescribe both an antibiotic and benzoyl peroxide. The benzoyl peroxide is needed to kill bacteria that the antibiotic misses.
In a study in India, researchers found 84 volunteers in their late teens and early 20’s who had an average of 25 active blackheads, whiteheads, and pimples on their faces at the beginning of their study. They asked half of the volunteers to use a combination of clindamycin and benzoyl peroxide creams and the other half of the volunteers to use a combination of nadifloxacin and benzoyl peroxide creams on their faces.
At the end of eight weeks, the volunteers who used clindamycin and benzoyl peroxide had an average of 16 blemishes on their faces. At the end of the same eight weeks, volunteers who used nadifloxacin and benzoyl peroxide had an average of 13 blemishes on their faces. Both groups still had on average about 3 pimples even after eight weeks of treatment. There was a better result from using both nadifloxacin and benzoyl peroxide, but not a significantly better result.
That hasn’t kept experts from touting nadifloxacin as a new “cure” for acne. You just need to know that it’s really not.
Multiple Treatments for Acne
Getting rid of acne bacteria doesn’t always get rid of acne. That’s because bacteria don’t inflame the skin. Your own immune system inflames the skin, and it can do that when there are no bacteria and it might not do that when there are bacteria. Acne bacteria survive by sending out chemicals that “trick” the immune system into destroying your pores rather than the bacteria themselves.
On the other hand, antibiotics often help. They just aren’t enough. You need to cleanse your face gently to remove excess oil. It’s important to cleanse your face without drying it out.
You need to stop excess production of oil in your pores by using treatments like either green tea extract creams or red light lamp therapy. You need to keep your pores open by removing dead skin that accumulates around them, either with a microdermabrasion cream or microdermabrasion cloth or with alpha- or beta-hydroxy acids. You need to manage both shine and flakiness of your skin and you need to make sure you aren’t using personal care products that make acne problems worse.
Antibiotics and benzoyl peroxide only address part of the problem. Complete acne care systems like Exposed Skin Care address the rest.