Efficacy of rifampin-moxifloxacin-metronidazole combination therapy in hidradenitis suppurativa.

Abstract

BACKGROUND:

Antibiotics have been shown to improve hidradenitis suppurativa (HS) patients but complete remission is rare using these treatments.

OBJECTIVE:

To assess the efficacy and safety of a combination of oral rifampin, moxifloxacin and metronidazole in long-lasting refractory HS.

METHODS:

We retrospectively studied 28 consecutive HS patients including 6, 10 and 12 Hurley stage 1, 2 and 3 patients, respectively. Complete remission, defined as a clearance of all inflammatory lesions including hypertrophic scars, was the main outcome criterion of the study.

RESULTS:

Complete remission was obtained in 16 patients, including 6/6, 8/10 and 2/12 patients with Hurley stage 1, 2 and 3, respectively (p=0.0004). The median duration of treatment to obtain complete remission was 2.4 (range 0.9-6.5) and 3.8 months (range 1.6-7.4) in stage 1 and 2 patients, respectively, and 6.2 and 12 months in the 2 stage 3 patients. Main adverse events of the treatments were gastrointestinal disorders (64% of patients) and vaginal candidiasis (35% of females). Reversible tendinopathy and hepatitis occurred in 4 and 1 patient, respectively.

CONCLUSIONS:

Complete remission of refractory HS can be obtained using broad-spectrum antibiotics and Hurley staging is a prognostic factor of response to the treatment.

• Authors: Olivier Join-Lambert, Hélène Coignard, Jean-Philippe Jais, Hélène Guet-Revillet, Sylvain Poirée, Sylvie Fraitag, Vincent Jullien, Florence Ribadeau-Dumas, Jacques Thèze, Anne-Sophie Le Guern, Sylvie Behillil, Anne Leflèche, Patrick Berche, Paul Henri Consigny, Olivier Lortholary, Xavier Nassif, Aude Nassif
• Journal: Dermatology (Basel, Switzerland) (Dermatology) Vol. 222 Issue 1 Pg. 49-58 (Feb 2011) ISSN: 1421-9832 [Electronic] Switzerland
• PMID: 21109728 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2010 S. Karger AG, Basel.

Chemical References

• Anti-Infective Agents
• Antibiotics, Antitubercular
• Aza Compounds
• Fluoroquinolones
• Quinolines
• Metronidazole
• Moxifloxacin
• Rifampin

Topics

• Adult
• Anti-Infective Agents (adverse effects, therapeutic use)
• Antibiotics, Antitubercular (adverse effects, therapeutic use)
• Aza Compounds (adverse effects, therapeutic use)
• Drug Therapy, Combination
• Female
• Fluoroquinolones
• Hidradenitis Suppurativa (drug therapy, pathology)
• Humans
• Kaplan-Meier Estimate
• Logistic Models
• Male
• Metronidazole (adverse effects, therapeutic use)
• Middle Aged
• Moxifloxacin
• Prognosis
• Quinolines (adverse effects, therapeutic use)
• Recurrence
• Remission Induction
• Retrospective Studies
• Rifampin (adverse effects, therapeutic use)
• Treatment Outcome
• Young Adult