Question

You hav initiated therapy for an 18 year old man with acne vulgaris and have prescribed doxycycline. He returns in three weekscomplaining that hi skin is no better. your next action is

A. counsel him that 6-8 weeks of treatment is often needed before significant improvement is achieved
B. discontinue the doxycycline and initiate mnocycline therapy
C. advise him that antibiotics are likely not an effective treatment for him and should not be continued.
D. add a second agent such as trimethoprim-sulfamethoxazole

Answer 1

The next action would be to counsel the patient that 6-8 weeks of treatment is often needed before significant improvement is achieved.

Step-by-step explanation:

If the patient returns in three weeks and complains that the skin is not better after initiating therapy for acne vulgaris with doxycycline, the next action would be to counsel the patient that 6-8 weeks of treatment is often needed before significant improvement is achieved (option A).

It is important to educate the patient about the timeline for improvement with acne treatment and to manage their expectations. Discontinuing the doxycycline and initiating minocycline therapy (option B) or advising the patient that antibiotics are likely not effective for him and should not be continued (option C) would not be appropriate at this stage.

Adding a second agent such as trimethoprim-sulfamethoxazole (option D) may be considered if the acne does not improve after a few months of monotherapy or if the acne is severe, but it is not the next step in this scenario.