BACKGROUND: Despite anecdotal evidence of a possibility of decreased effectiveness of oral contraceptives (OCs) with some antibiotics, it is not known whether antibiotic use in dermatologic practices engenders any increased risk of accidental pregnancy. OBJECTIVE: Our purpose was to examine the effect of commonly prescribed oral antibiotics (tetracyclines, penicillins, cephalosporins) on the failure rate of OCs. METHODS: The records from three dermatology practices were reviewed, and 356 patients with a history of combined oral antibiotic/OC use were surveyed retrospectively. Of these patients, 263 also provided "control" data (during the times they used OCs alone). An additional 162 patients provided control data only. RESULTS: Five pregnancies occurred in 311 woman-years of combined antibiotic/OC exposure (1.6% per year failure rate) compared with 12 pregnancies in 1245 woman-years of exposure (0.96% per year) for the 425 control patients. This difference was not significant (p = 0.4), and the 95% confidence interval on the difference (-0.81, 2.1) ruled out a substantial difference (> 2.1% per year). There was also no significant difference between OC failure rates for the women who provided data under both conditions, nor between the two control groups. All our data groups had failure rates below the 3% or higher per year, which are typically found in the United States. CONCLUSION: The difference in failure rates of OCs when taken concurrently with antibiotics commonly used in dermatology versus OC use alone suggests that these antibiotics do not increase the risk of pregnancy. Physicians and patients need to recognize that the expected OC failure rate, regardless of antibiotic use, is at least 1% per year and it is not yet possible to predict in whom OCs may fail.

Administration, Oral↗

PubMed1997

Bedside testing: the diagnostic cornerstone of dermatology.

Explore the source record for details and available documents.

Diagnosis, Differential↗

PubMed1994

A practical approach to antibiotic treatment in women taking oral contraceptives.

Clinical situations that require the use of systemic antibiotic therapy are common. Because millions of women choose oral contraceptives for birth control, the potential for interaction between these drugs frequently has to be considered. We review the available information and present a practical approach for dealing with this situation based on sharing responsibility with an educated patient.

Adult↗

PubMed1991

Office dermatologic testing: the KOH preparation.

A potassium hydroxide preparation is used to confirm the diagnosis of a superficial fungal skin infection. Adding black or blue-black ink to the potassium hydroxide solution highlights fungal organisms and distinguishes them from surrounding cellular debris.

Biopsy↗

PubMed1991

Office dermatologic testing: the scabies preparation.

Patients with scabies may present with urticarial, eczematous or excoriated papules, eczematous patches or, occasionally, nodules. It is often difficult to differentiate scabies from eczema, folliculitis, drug eruption or lichen planus. The classically described burrows are often not seen. The scabies preparation, as described in this article, will aid in making the proper diagnosis.

Clinical Protocols↗

PubMed1991

Office dermatologic testing: the Tzanck preparation.

Whether a vesicobullous disease is intraepidermal or subepidermal is often difficult to determine from the clinical examination. The Tzanck preparation can provide clues that aid in the diagnosis of a number of diseases. It is particularly helpful in confirming the diagnosis of herpes infection. This article outlines the materials and steps for performing this valuable test.

Azure Stains↗

PubMedDate not supplied

Prescription errors. Legibility and drug name confusion.

Inadvertent drug substitution occurred in several instances in our practices due to the combination of the physician's illegible handwriting on prescriptions and the pharmacist's misinterpretation of subtle clues, which might have prevented the errors. The literature on the legibility of physician handwriting is reviewed. Our specific recommendations include using preprinted prescription pads, training staff assistants who write prescriptions, printing complete directions on each prescription, and aggressively educating each patient about the name and purpose of all drugs being prescribed. Patients are encouraged to bring their medications to each office visit to identify potential errors.

Handwriting↗