Oral antibiotics are useful as part of acne treatment when lesions are inflamed, have collections of pus or when it presents with nodules and cysts.
Although antibiotics lead to improvement in some people, it comes with a cost. It has been associated with changes in the resident gut bacteria and also an increase in the incidence of infections in the upper respiratory tract in one hand and bacterial resistance in the other.
An interesting study done at the department of dermatology at the New York University showed that many patients have been taking antibiotics at an average of 11 months which surpasses recommended guidelines which limit the use up to 3 months.
Oral antibiotics can be effective clearing acne lesions. However, there are some cases where they are not so effective. In those cases dermatologists and patients should discuss the direction of the treatment with alternative and stronger options depending on each person.
Nagler AR, Milam EC, Orlow SJ. The use of oral antibiotics before isotretinoin therapy in patients with acne. J Am Acad Dermatol. 2016 Feb;74(2):273-9.