Efficacy of Rifampin-Moxifloxacin-Metronidazole Combination Therapy in Hidradenitis Suppurativa

Olivier Join-Lambert (1) , Hélène Coignard (2, 3) , Jean-Philippe Jais (4, 2) , Hélène Guet-Revillet (1) , Sylvain Poirée (5) , Sylvie Fraitag (6) , Vincent Jullien (7) , Florence Ribadeau-Dumas (8) , Jacques Thèze (8) , Anne-Sophie Le Guern (8) , Sylvie Behillil (8) , Anne Leflèche (9) , Patrick Berche (5) , Paul Henri Consigny (8) , Olivier Lortholary (3, 2) , Xavier Nassif (1) , Aude Nassif (8)

1 Inserm U1002 - Pathogénie des infections systémiques
2 UPD5 - Université Paris Descartes - Paris 5
3 Service des Maladies infectieuses et tropicales [CHU Necker]
4 Service d'informatique médicale et biostatistiques [CHU Necker]
5 Centre d'infectiologie Necker-Pasteur [CHU Necker]
6 Service d'Anatomie et de Cytologie Pathologiques
7 Hôpital Saint-Vincent de Paul
8 CMIP - Centre Médical de l'Institut Pasteur
9 CIBU - Cellule d'Intervention Biologique d'Urgence - Laboratory for Urgent Response to Biological Threats

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.

Domains: Life Sciences [q-bio]

Olivier Join-Lambert, Hélène Coignard, Jean-Philippe Jais, Hélène Guet-Revillet, Sylvain Poirée, et al.. Efficacy of Rifampin-Moxifloxacin-Metronidazole Combination Therapy in Hidradenitis Suppurativa. Dermatology, 2011, 222 (1), pp.49-58. ⟨10.1159/000321716⟩. ⟨pasteur-02572642⟩