The DTB review found that the NHS spent £9.3 million on minocycline last year although it is likely that a proportion of this was not for patients with acne. The same volume of doxycycline would have cost £3.9 million, a saving of £5.4 million.
The BNF recommends that oral antibiotic therapy should be reserved for second line when topical treatment is not adequately effective or is inappropriate.
Action: Topical treatment is first line for moderate to severe acne. Where oral treatment is necessary, a cost effective option (e.g. doxycycline) should be used and the patient warned about the potential harms.
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