A 10-to-12-week course of combined clindamycin/rifampicin or tetracyclines are the first-line medical treatment for moderate-to-severe HS. A recent multicenter European study revealed significant efficacy of oral clindamycin/rifampicin and tetracyclines without differences between them, independently of baseline HS severity. Our study explored the efficacy of a treatment induction with a 5-day loading dose of i.v. clindamycin (3x600 mg/d) prior to the oral clindamycin/rifampicin combination, in 95 consecutive, previous treatment-naive adult HS patients. The patients were assessed for severity using the IHS4 and the DLQI before (T0) and immediately after the 5-day treatment with i.v. clindamycin (T1), as well as after a 10-12-week period of oral clindamycin/rifampicin treatment (T2). Data groups (T1 vs. T0 and T2 vs. T1) were evaluated using Wilcoxon’s signed rank test. p<0.05. After a Bonferroni correction, the results were considered significant at p<0.008. The IHS4 median value (interquartile range [IQR]) was reduced from 10 (5-20) at T0, to 7 (3-14) at T1 (p<0.001), and 4 (1–12) at T2 (p<0.001 in comparison to T0; n.s. in comparison to T1). DLQI median value (IQR) decreased from 17 (7-21) at T0, to 8 (5-19) at T1 (p=0.002), without further reduction at T2: 8 (2-16; p<0.001 in comparison to T0, n.s. in comparison to T1). In conclusion, a significant improvement of HS severity and quality of life was demonstrated after a 5-day i.v. clindamycin treatment, which was maintained during the S1-European guideline-recommended oral clindamycin/rifampicin course. These data indicate that the overall antiinflammatory effect of antibiotics can be accelerated, achieved through a 5-day i.v. clindamycin course, so more effective treatments can be initiated thereafter.

ESDR064 - Short-term intravenous clindamycin accelerates the benefit of oral clindamycin-rifampicin treatment in hidradenitis suppurativa (HS)

50th Annual Meeting of the European Society for Dermatological Research. VIRTUAL MEETING