In a small, preliminary study investigating the effects of aggressive antibiotic therapy in patients with advanced, refractory cutaneous T-cell lymphomas (CTCLs), the broad-spectrum antibiotic carbapenem improved clinical symptoms. Results were published in Blood.

In patients with CTCL, infection with Staphylococcus aureus is a major contributor to morbidity and mortality. Additionally, enterotoxin production by S. aureus can act as a superantigen and potent activator of T cells in vitro, and it may play a role in the etiology and progression of CTCL. In previous research, antibiotics decreased tumor burden in patients with CTCL.

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In this study, 8 patients with advanced-stage, treatment-refractory CTCL and cutaneous lesions colonized by S. aureus received carbapenem. Six patients were male, and patients were between 57 years old and 74 years old.

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All patients exhibited skin lesions with the presence of S. aureus at the beginning of the trial, but S. aureus could not be identified in 6 of 8 patients after 10 days. Absence of S. aureus persisted in 5 of the 6 patients at 1 month, and 3 of the 5 patients lacked S. aureus after 2 months. Six of the study participants had malignant T-cell clones in their biopsied skin, but antibiotic treatment reduced these levels after 60 days.

“[W]e provide the first evidence that aggressive antibiotic treatment inhibited proliferation of malignant T cells and disease activity in [patients with] advanced-stage CTCL,” the authors stated.

Immunohistochemistry, global mRNA expression, and cell-signaling pathway analysis in lesional skin suggested a general decrease in expression of CD25, STAT3 signaling, and cellular proliferation throughout the antibiotic treatment regimen. Gene expression profiles in several patients’ samples suggested healthy skin after 2 months of antibiotics.

The authors concluded that their research “provides novel evidence for a potential link between antibiotic treatment of S. aureus and disease activity as well as a rationale for aggressive antibiotic treatment as an important adjuvant therapy in patients with severe [CTCL] and lesional skin colonization with toxin-producing S. aureus.”


1.     Lindahl LM, Willerslev-Olsen A, Gjerdrum LM, et al. Antibiotics inhibit tumor and disease activity in cutaneous T-cell lymphoma [published online July 22, 2019]. Blood. doi:10.1182/blood.2018888107