Clindamycin versus clindamycin plus rifampicin in Hidradenitis Suppurativa treatment: clinical and ultrasound observations

Publication date: Available online 28 November 2018

Source: Journal of the American Academy of Dermatology

Author(s): Raffaele Dante Caposiena Caro, Maria Vittoria Cannizzaro, Elisabetta Botti, Cosimo Di Raimondo, Eleonora Di Matteo, Roberta Gaziano, Luca Bianchi

Abstract

Background

Antibiotics are recognized as first-line treatments for Hidradenitis Suppurativa (HS), but there is limited data on their efficacy.

Objective

Evaluate the efficacy of oral clindamycin versus clindamycin plus rifampicin in HS patients.

Methods

Sixty mild to moderate-severe HS patients classified according IHS4 and Hurley scores, were subdivided into two groups of 30 patients each (Group A receiving clindamycin+rifampicin and Group B treated with clindamycin alone), and retrospectively studied. The main outcome was to evaluate and compare the clinical and ultrasound response between groups after 8 weeks of treatment according to Hidradenitis Suppurativa Clinical Response (HiSCR).

Results

After the treatment, 17/30 patients in Group A and 19/30 in Group B met the primary outcome. Both groups showed a similar improvement of IHS4, while DLQI and Pain VAS improved more in Group B. In particular, nodules and abscesses count reduction was similar between the two groups. Whereas, the number of draining tunnels decreased more in Group B. The factors significantly associated with HiSCR were age, BMI, IHS4 and absence of axillary involvement. The disease free survival was similar between the two groups.

Limitations

The study was not randomized or placebo-controlled.

Conclusion

Clindamycin may be a useful treatment alternative to antibiotic combination regardless of HS clinical stage.

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