Abstract:

Context: Acne vulgaris is the most common psychologically distressing skin disorder which is treated with indiscriminate use of oral and topical antibiotics mainly targeted against the anaerobic organism Propionibacterium acnes,without much consideration given to other causative micro-organisms.

Objectives: This study was therefore undertaken to isolate the probable aerobic organisms causing acne vulgaris and to demonstrate the resistance and sensitivity pattern to the commonly used antibiotic Clindamycin. Also traditional acne medications like Berberis aquifolium and Azadirachta indica which are supposed to have antimicrobial effects and are used as over the counter medications were tested against the isolated microbes to make a comparative study. This type of comparative study is first of its kind and shall help the dermatologists to select judicially from the cafeteria of medications available for treating acne.

Design: prospective comparative study of three months duration.

Study setting: patients attending Dermatology OPD of Bowring and Lady Curzon Hospital

Patients presenting with pustular or nodulocystic acne, between 13 to 50 years of age.

Results: 40 patients were included in the study among which 70 %( 28 patients) belonged to age group 20-29 year. Samples from 40% (16) patients showed growth of Staphylococcus aureus organism on aerobic culture. Followed by 32.5 %( 13) samples isolating Coagulase negative Staphylococcus aureus (CONS). 68.8% of isolated Staphylococcus aureus showed sensitivity to Clindamycin, 12.5% showed sensitivity to Berberis aquifolium and 18.8%showed sensitivity to Neem.

76.9%, 69.2% and 30.8% samples which grew Coagulase negative Staphyloccocus aureus (CONS) showed sensitivity to Clindamycin, Berberis aquifolium and Neem respectively. Gram negative organisms showed resistance to all three medications.

Conclusion: This study shows that Staphylococcus aureus and CONS are most commonly isolated aerobic organism from acne. These are still sensitive to Clindamycin compared to medications of other systems of acne management like homoeopathy and ayurveda .CONS showed significant sensitivity to homeopathic medication too. We suggest in vivo studies for better evaluation and comparison.

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