Teledermatology and Modulation of Antibiotic Dose in Acne Vulgaris

Study Overview
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Brief Summary
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To see if teledermatology can be used to reduce antibiotic burden in patients on doxycycline or minocycline for acne vulgaris

Detailed Description
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The investigators are going to ascertain if antibiotic burden can be reduced with tele dermatology use. There are two arms of the study: Feedback group Non feedback group All subjects will be randomised to either group, all subjects will take photos of their face and answer questions at baseline, visit 2 (1 month), visit 3 (2 months), visit 4 (3 months). The investigators will then use measurements of acne grading (patient grading, investigator global assessment, lesion counting, global acne grading) to reduce/taper antibiotics in the feedback group.

Official Title
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Teledermatology and Modulation of Antibiotic Dose in Acne Vulgaris

Conditions
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Acne Vulgaris

Intervention / Treatment
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* Other: Feedback group
* Other: Non Feedback group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subjects aged 15 years and older Subjects who have been prescribed doxycycline or minocycline by their physician for acne vulgaris but have not initiated treatment yet. Exclusion Criteria: Subjects who have used isotretinoin in the last 6 weeks Those who have used oral antibiotics within the last 4 weeks Those who have been initiated or changed brand of oral contraceptive pill within the last one month. Those subjects who cannot engage with the teledermatology platform Prisoners Adults unable to consent

Ages Eligible for Study
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Minimum Age: 15 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Non Feedback<br>No feedback given to this group regarding their antibiotic use Subjects take images and answer questions during the study like the feedback group, but in this group no feedback re dosing is given. | Other: Non Feedback group<br>* To use as control to see if antibiotic burden has been reduced in the active feedback group<br>|
| Active Comparator: Feedback group<br>Feedback given to this group regarding their antibiotic use after baseline. If the subject is in the feedback group, after this visit, a dermatologist will review all images and the survey results and give the patient information about whether they should: Continue current dose Reduce dose if there is at least a one point improvement in both the investigator acne global assessment AND the patient acne global assessment scores: A dose reduction will be such that the dose is halved from the previous dose. For example if the subject is on minocycline or doxycycline 100 mg twice daily, they will be reduced to minocycline or doxycycline 100 mg daily. Increase dose if had been previously reduced, dose will not be increased beyond the initial starting dose. | Other: Feedback group<br>* Monitoring ability to use teledermatology to modify antibiotic burden<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reduced antibiotic use | The difference in antibiotic exposure in the physician feedback group compared to those not receiving feedback | Assessed at 4, 8, 12 weeks |