American Journal of Clinical Dermatology

, Volume 4, Issue 4, pp 273–276 | Cite as

Treatment of Gram-Negative Folliculitis in Patients with Acne

Therapy In Practice


Gram-negative folliculitis may be the result of long-term antibacterial treatment in acne patients. It is caused by bacterial interference and replacement of the Gram-positive flora of the facial skin and the mucous membranes of the nose and infestation with Gram-negative bacteria. These Gram-negative bacteria include Escherischia coli, Pseudomonas aeruginosa, Serratia marescens, Klebsiella and Proteus mirabilis. The occurrence of Gram-negative folliculitis should be considered in acne patients in whom oral treatment with tetracyclines has not resulted in a significant improvement of acne lesions after 3–6 months’ treatment. The occurrence of Gram-negative folliculitis in acne patients is believed to be generally underestimated, since correct sampling and bacteriology is rarely performed by clinicians. Gram-negative folliculitis in acne and rosacea patients is best treated with isotretinoin (0.5–1 mg/kg daily for 4–5 months).


Acne Isotretinoin Rosacea Antibacterial Treatment Pyoderma 
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No sources of funding were used to assist in the preparation of this manuscript. The authors have no conflicts of interest that are directly relevant to the content of this manuscript.


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Copyright information

© Adis International Limited 2003

Authors and Affiliations

  1. 1.Department of DermatologyUniversity HospitalZürichSwitzerland

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