Oral Antibiotic
Antibiotics are effective for inflammatory acne because of their
antibiotic activity and anti-inflammatory effects (54). It is
recommended to use oral antibiotics as second-line therapy for
short-term management and as an adjunctive treatment when hormonal
therapies alone are inadequate (42). Tetracyclines, mainly doxycycline
and minocycline, are the most commonly prescribed agents (55).
Macrolides such as azithromycin are commonly used when tetracyclines are
not tolerated or contraindicated (56). Monotherapy with oral antibiotics
should be avoided to reduce the development of antibiotic-resistant
Propionibacterium acnes (P acne), and limit the treatment to 3-6 months
(57). Trimethoprim/sulfamethoxazole, penicillins, and cephalosporins
have evidence support their efficacy to use for acne (44, 58).