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Why Antibiotics Often Fail in Hidradenitis Suppurativa

Why Antibiotics Often Fail in Hidradenitis Suppurativa

Patients with Hidradenitis Suppurativa (HS) are always colonized, but rarely infected with bacteria. Even then, it is poorly understood why antibiotics don’t work well for them. New research has found that bacteria form shields, particularly in HS, which block the action of antibiotics. These shields are called biofilms, and can be very effective in making patients miserable. We are now using a combination of Kenalog and clindamycin, injected into the lesions of HS, to help break the shields and allow the antibiotics to get in and do their work. Clindamycin is a mainstay in the treatment of HS, on the skin, through the mouth and now injected into individual lesions. It is anti-inflammatory as well as antibacterial. New regimens of antibiotics have also been devised to reduce the shields and calm the inflammation that is the main source of destruction in HS. While there are no guarantees, these new developments should go a long way in making patients with HS feel better!

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