Antibiotics for HS: Why They Do & Don't Work

How many of us have left the doctor with a prescription for a new antibiotic as the next in our long line of treatment offerings? In most cases antibiotics are given because the doctors simply don't know what else to do. Long term antibiotic use is not a suitable treatment for HS.

In the past, antibiotics were primarily given because it was believed that HS was a form of acne. Unless you have an actual infection, antibiotics are usually being prescribed to try to reduce inflammation or as an antimicrobial treatment, however, in many cases without a culture or confirmation of a bacteria microorganism being present.

Typically HS abscesses are not the result of an infection. This does not mean that abscesses cannot become infected, but HS is not an infectious disease.

Why You See Initial Improvement on Antibiotics

A common scenario for those treated with antibiotics for HS is that you seem to get better in the beginning, but then your HS starts to come back, usually with a vengeance. It has been explained by some specialists that you may see initial improvement if bacteria microorganisms were initially present and the antibiotic resolved that bacteria. This may make antibiotics beneficial for a period of time, but once you find yourself in a situation where the antibiotic stops working, then what? Typically you’re moved to a different strain of antibiotics and this cycle continues until (in many cases) antibiotic resistance happens meaning you become resistant or allergic to antibiotics.

There are some doctors who prescribe two or three different kinds of antibiotics at a time or prescribe a very strong antibiotic (Bactrim for example), which has the same effect described above. The issue with this is the potential of becoming resistant to antibiotics. If you develop chronic staph infections and/or MRSA you do not want to be resistant to antibiotics, this creates a serious and sometimes life threatening situation. Antibiotics can also weaken your immune system, which does not help with healing abscesses or wounds.

Resistance & Complications

Antibiotic resistance occurs when the germs (bacteria or fungi) no longer respond to the antibiotics designed to eliminate them; this means the germs are not controlled and continue to grow.

A common misconception is that a person's body becomes resistant to specific antibiotics, however it is the bacteria that becomes resistant, not the person.

Antibiotic resistance can occur naturally however, each time you take an antibiotic unnecessarily or improperly you increase the chance of developing medicine-resistant bacteria(s). Bacteria and fungi are constantly finding new ways to avoid the effects of antibiotics.

Taking antibiotics only when necessary is one way you can protect yourself from antibiotic resistance.

Some antibiotics have been known to cause drug-induced lupus for example Minocycline.

Some scientists believe that taking long-term antibiotics can come with a range of problems associated with; glucose metabolism, the immune system, food digestion.

Chronic Infections

While it is not common, some HS sufferers that deal with chronic infection such as Staph, MRSA, etc. This doesn't necessarily have to be HS abscesses; they are just prone to infections. In these cases long-term antibiotics are sometimes necessary. These people must take these antibiotics to avoid life-threatening situations and infections.

Note: In the UK, various antibiotic options such as Clindamycin/Rifampcin will have to be tried and eliminated, per treatment guidelines, prior to being considered for biologic treatments such as Humira.

Antibiotic Concerns

Fluoroquinolone type antibiotics should be reserved for use in patients with conditions who have no alternative treatment options.

The FDA is strengthening its warning regarding fluoroquinolone as it has been linked to sudden, serious, and potentially permanent nerve damage called peripheral neuropathy along with other serious health complications. Peripheral neuropathy is damage to the nerves that send information to and from the brain and spinal cord and the rest of the body. It can also cause long-lasting, disabling and potentially permanent side effects involving tendons, muscles, joints and the nervous system problems. Other side effects include inflamed or torn tendon, muscle pain or weakness, and joint pain or swelling,walking difficulty, feeling pins and needles, burning pain, tiredness, depression, problems with memory, sleeping, vision, hearing, altered taste and smell, arthralgia, pain in extremities, and gait disturbance. Tendon swelling and injury may occur within 2 days of starting treatment with a fluoroquinolone, but may even occur several months after stopping treatment.

More than 23 million patients received a prescription for one of these medications in 2011 alone.

These medicines include:

  • Ciprofloxacin (Cipro)

  • Gemifloxacin (Factive)

  • Levofloxacin (Levaquin)

  • Moxifloxacin (Avelox)

  • Norfloxacin(Noroxin)

  • Ofloxacin (Floxin)

Antibiotic resistant and side effect information references:

Johns Hopkins medicine

Scientific America


WHO (World Health Organization)

Catharine Paddock, Ph.D.

Read about treatment options here.

Content in this article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking treatment because of something you have read on this website.

Written by Denise Panter-Fixsen

Edited by Brindley Kons


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