Background: C. acnes is involved in acne.

Aim: To assess the evolution of C. acnes phylotypes,the antimicrobial activity, the risk for inducing antibiotic resistance emergence and the clinical efficacy of a cream containing niacinamide and gluconolactone.

Methods: Prospective, open-label, non-comparative study performed in 21 adult patients with almost no or mild facial acne according to the GEA score.

The main evaluation criterion was the genomic analysis of C. acnes phylotypes, using standard methods and clinical assessments made at baseline and Day56. Adverse events were reported throughout the study.

Results: At baseline, the mean age was 23.5±5.5 years, 85.7% of the patients were female, main C. acnes phylotype was IA1 (71.4%). A C. acnes strain, resistant to clindamycin and erythromycin, potentially due to a mutation at position A2059G, was observed in two patients. The mean number of inflammatory lesions was 13.1±3.6 and the number of open or closed come dones was 20.2±5.4. At Day 56, a shift to a different C. acnes phylotype was observed in eight patients; in seven patients phylotypes remained unchanged. C. granulosum was still present in one patient, while no resistance or intermediate sensitivity was observed anymore. In one patient, RNA mutation 16S was absent, despite an intermediate susceptibility to tetracycline. The cream caused no antibiotic resistance emergence. Inflammatory and non-inflammatory lesion count and global severity had significantly improved from baseline; safety was excellent.

Conclusion: The tested cream improves acne by modifying C. acnes phylotypes, thus changing the C. acnes population, without causing antibiotic resistance emergence.

Keywords: Acne, C. acnes phylotypes, gluconolactone, niacinamide, antibiotic resistance, inflammatory lesions, microbiota.

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Brigitte Dréno

UF dermato-cancérologie, CHU Nantes-Hôtel-dieu, Inserm U1232,

CIC Biothérapie Inserm 05031 Place Alexis Ricordeau, 44093 Nantes cedex 01, France

Phone. 00332 40 08 32 80, Fax. 00332 40 08 31 17, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.