Coprescription of Isotretinoin and Tetracyclines for Acne is Rare: An Analysis of the National Ambulatory Medical Care Survey.

Introduction: Systemic therapy for acne can include tetracyclines or, for severe cases, isotretinoin. Concurrent use of tetracyclines and isotretinoin is known to increase the risk of development of pseudotumor cerebri (PTC). Objectives: Given their association with PTC when used concomitantly, this study sought to quantify the estimated frequency of the coprescription of isotretinoin and tetracyclines and to assess for trends in the use of isotretinoin and tetracycline for acne as it relates to age, sex, race, insurance, and provider specialty. Methods: Data from the National Ambulatory Medical Care Survey were analyzed over the years 2003 to 2013 regarding acne visits with isotretinoin and/or tetracycline prescriptions. Complex-samples logistic regression was used to estimate the effect of demographic variables on prescribing behavior. Results: Isotretinoin and tetracyclines were coprescribed in 0.35 percent of visits for acne. Dermatologists prescribed isotretinoin more frequently than nondermatologists. Patients younger than 36 years of age and men were more likely to receive treatment with isotretinoin or a tetracycline. No differences in prescribing patterns were found based on race or survey year. Conclusions: Concomitant exposure to tetracyclines and isotretinoin is exceedingly rare. The increased PTC risk associated with their concomitant use is well-known among dermatologists.