Received: 28.09.2026
Accepted: 19.10.2026
Published online: 30.10.2026
UDC: 616.53-002.25:615.03:579.61
DOI: 10.53511/pharmkaz.2026.5.2
Article type: Original research article
(pilot cross-sectional clinical and microbiological study)
CLINICAL PHARMACOLOGICAL PERSPECTIVES OF ADJUVANT PROBIOTIC THERAPY IN ACNE VULGARIS: RESULTS OF A PILOT CULTURE-BASED STUDY OF THE INTESTINAL MICROBIOTA
Dzhumabayeva A.A.¹, Abuova G.N.¹
¹ South Kazakhstan Medical Academy JSC, Shymkent, Kazakhstan
Introduction. Adjunctive probiotics in acne vulgaris are being considered in relation to the safety of systemic pharmacotherapy and the potential gut–skin interaction. Characterising the intestinal microbial profile may inform the design of future clinical pharmacology studies. However, culture-based observations alone cannot establish the efficacy or safety of a probiotic product.
Objective. To characterise alterations in cultivable intestinal microflora among patients with acne vulgaris and assess their relevance to the design of future studies of adjunctive probiotic pharmacotherapy.
Materials and Methods. A cross-sectional clinical and microbiological study enrolled 14 patients with acne vulgaris (aged 24-45 years; median age, 30.5 years; 12 females, 2 males) evaluated in Shymkent between January and March 2026. Quantitative stool bacteriological culture was performed to assess indigenous taxa (Lactobacillus spp., Bifidobacterium spp., Enterococcus spp., typical Escherichia coli) and opportunistic pathogens. Descriptive statistical analyses were applied.
Results. A reduction in Lactobacillus spp. was identified in all 14 patients (100.0%), Bifidobacterium spp. in 11 (78.6%), Enterococcus spp. in 9 (64.3%), and typical E. coli in 8 (57.1%). Concurrent deficiency of ≥2 indigenous groups was detected across 100% of participants. Overgrowth of opportunistic microorganisms was documented in 6 (42.9%) patients (Clostridium spp., 21.4%; Staphylococcus aureus, Candida glabrata, and Proteus mirabilis, 7.1% each). A deficiency profile was established in 8 (57.1%) and a mixed profile in 6 (42.9%) individuals.
Discussion. The observed culture-based profiles may inform baseline characterisation in future clinical pharmacology studies of adjunctive probiotics. This study did not assess drug exposure, clinical efficacy, safety or antibiotic-sparing effects. The small sample, absence of a comparator group and limitations of culture-based testing restrict interpretation.
Conclusion. Reduced levels of cultivable Lactobacillus spp. and Bifidobacterium spp. were common in this patient group. These findings may support hypothesis generation and the design of controlled clinical pharmacology studies, but do not establish an indication for specific probiotic strains, doses or formulations.
Keywords: acne vulgaris; pharmacotherapy; probiotic preparations; pharmabiotics; gut-skin axis; Lactobacillus; Bifidobacterium; antimicrobial resistance.
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