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

Dermatology. 2011 Feb;222(1):49-58. doi: 10.1159/000321716. Epub 2010 Nov 25.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

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

Substances

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