Antibiotic Usage for Hidradenitis Suppurativa: Risk for Infection and Death

Introduction

Hidradenitis Suppurativa (HS) is an inflammatory skin condition that disproportionately affects young Black adult females. Antibiotics are commonly used for disease management, making it important to consider the potential complications such as infection and death. The literature has started to examine the relationship between patients with HS and Clostridium Difficile (C.diff), but only with smaller studies, and no studies have examined the death rate. This study investigates the risk for infection of C. diff and death for patients with HS.

Methods

A retrospective cohort study was performed utilizing the global database TriNetX. Two cohorts were assembled that were compared in their development of C.diff or death. The first cohort included patients who used various antibiotics after their HS diagnosis (n = 86,251). The second cohort served as the control and included patients with HS that did not use these antibiotics (n = 60,157). For the statistical analysis, the risk ratio was calculated. The antibiotics examined included Clindamycin, Rifampin, Tetracycline, Minocycline, and Doxycycline.

Results

The risk ratio and associated 95% confidence intervals for contracting C.diff or death is 2.265 (1.971, 2.604) and 1.357 (1.284, 1.434), respectively.

Conclusion

The results show a statistically significant increased risk of developing a C.diff infection and of dying when utilizing these antibiotics. Antibiotic usage has shown to improve HS symptoms, however, clinicians must be wary about the complications that could occur when prescribing antibiotics, such as increased risk of C.diff infection and death.