"In a finding that suggests the potential for practice change that would reduce the use of antibiotics in dermatology researchers in the Perelman School of Medicine at the University of Pennsylvania have found the diuretic drug spironolactone may be just as effective as antibiotics for the treatment of womens acne. The study published this month in the Journal of Drugs and Dermatology found patients who were originally prescribed spironolactone changed to a different drug within one year at almost the same rate as those who were prescribed antibiotics. The prescription change is a proxy for ineffectiveness since switching is often the result of treatment failure due to lack of efficacy side effects cost or other factors.  Acne is one of the most common diseases in the world. It affects  percent of people under the age of  but it also regularly impacts adults. More than  percent of women in the United States are treated for acne between the ages of  and  while more than  percent are treated between the ages of  and .  Oral antibiotics are the most common systemic treatment for acne and when combined with the large patient population the result is that dermatologists prescribe the highest level of antibiotics per provider among all medical specialties according to the Centers for Disease Control  a fact that contributes to concerns about increased resistance to antibiotics across all fields of medicine. Its clear that a safe alternative to oral antibiotics could have a huge benefit and our data show spironolactone may be that alternative said the studys lead author John S. Barbieri MD MBA Dermatology chief resident at Penn. David J. Margolis MD PhD a professor of Dermatology was the studys senior author. Spironolactone marketed under the name aldactone is currently approved to treat high blood pressure heart failure and conditions that cause people to retain fluid. It blocks the effects of male hormones like androgen meaning its not an option to treat acne in men. However those same antihormonal effects can help prevent acne outbreaks in women. As a result some dermatologists use it to treat female acne patients. Researchers compared data on  women and girls taking spironolactone to  who were prescribed antibiotics. Within a year . percent of spironolactone patients and . percent of antibiotic patients had switched to alternative treatments suggesting each treatment was working at almost the same rate despite the fact that tetracyclineclass antibiotics are prescribed five times as frequently. These numbers suggest dermatologists should consider spironolactone first instead of antibiotics when it comes to women with acne Barbieri said. In addition to the benefits for antibiotic stewardship Barbieri pointed to several studies showing longterm oral antibiotic use may be associated with antibiotic resistance lupus inflammatory bowel disease and even colon and breast cancer. This indicates spironolactone may have a better safety profile than oral antibiotics which is another factor that makes it such an appealing option Barbieri said. He also noted spironolactone is less expensive which may be relevant to patients with high deductibles or who are uninsured. Spironolactone is not approved for the treatment of acne by the U.S. Food and Drug Administration despite expert opinion supporting its use and Barbieri says the findings of this study should be confirmed by a randomized controlled trial that directly compares the two treatment options. Penn Medicine is one of the worlds leading academic medical centers dedicated to the related missions of medical education biomedical research and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania founded in  as the nations first medical school and the University of Pennsylvania Health System which together form a . billion enterprise. The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than  years according to U.S. News  World Reports survey of researchoriented medical schools. The School is consistently among the nations top recipients of funding from the National Institutes of Health with  million awarded in the  fiscal year.  The University of Pennsylvania Health Systems patient care facilities include The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center  which are recognized as one of the nations top Honor Roll hospitals by U.S. News  World Report  Chester County Hospital Lancaster General Health Penn Medicine Princeton Health Penn Wissahickon Hospice and Pennsylvania Hospital  the nations first hospital founded in . Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Good Shepherd Penn Partners a partnership between Good Shepherd Rehabilitation Network and Penn Medicine and Princeton House Behavioral Health a leading provider of highly skilled and compassionate behavioral healthcare. Penn Medicine is committed to improving lives and health through a variety of communitybased programs and activities. In fiscal year  Penn Medicine provided more than  million to benefit our community."