Oral Antibiotics

Clindamycin Capsules

Oral Antibiotics are ingested by mouth and affect the whole body. Oral antibiotics work by killing the bacteria that contribute to acne symptoms. Oral antibiotics can be very effective acne treatments, but they have a higher risk of side effects than topical antibiotics. Therefore, oral antibiotics are usually only used to treat moderate to severe acne (Acne Types: 2-4). Oral antibiotics are often combined with complementary therapeis in holistic acne treatment regimens.

There are many different kinds of antibiotics. Some antibiotics are more effective for the treatment of acne than others. Below is a ranked list of all of the oral antibiotics that are routinely used for the treatment of acne. Our antibiotic ranking system (Scored on a 1 {BAD} to 100 {GOOD} scale) is based on patient reports, clinical research results and antibiotic susceptibility testing scores from a variety of sources. Click on an antibiotic to learn more about that particular medication.

Oral Antibiotics

Topical Antibiotics

Acne Patients Should Avoid Comedogenic Substances

Topical Antibiotics are administered directly to the skin. They work by killing the bacteria that contribute to acne symptoms. Topical antibiotics are very common treatments for all types of acne vulgaris (Acne Types: 1-4). Topical antibiotics tend to have fewer and milder side effects than orally administered antibiotics. For individuals with moderate to severe acne symptoms (Acne Types: 3-4), topical antibiotics are often combined with a complementary therapies in holistic acne treatment regimens.

There are many different kinds of antibiotics. Some antibiotics are more effective for the treatment of acne than others. Below is a ranked list of all of the topical antibiotics that are routinely used for the treatment of acne. Our antibiotic ranking system (Scored on a 1 {BAD} to 100 {GOOD} Scale) is based on patient reports, clinical research results and antibiotic susceptibility testing scores from a variety of sources. Click on an antibiotic to learn more about that particular medication.

Topical Antibiotics

Trimethoprim

Trimethoprim 200mg Tablets

Trimethoprim (TMP) is an antibiotic that is used to treat certain types of urinary tract, ear and intestinal infections that are caused by bacteria. It is is commonly included in combination antibiotics with Sulfamtheoxazole, Dapsone and other Sulfonamide antibiotics.

Trimethoprim inhibits the ability of bacteria to synthesize vitamin B9 (Folate) by a mechanism that complements the antibacterial activity of Sulfonamide antibiotics.

Trimethoprim is occasionally used alone as a treatment for acne. There is limited clinical research into the efficacy of Trimethoprim alone as an acne treatment, but some acne patients have reported positive results with this medication.

Laboratory testing indicates that the acne-causing P. acnes bacterium tends to be moderately susceptible to Trimethoprim, but Trimethoprim-resistant P. acnes are becoming more common in some places.

The combination of Trimethoprim plus Sulfamethoxazole (CoTrimoxazole) is a more common and effective acne treatment. Oral Cotrimoxazole can be a very effective treatment for some individuals with moderate to severe inflammatory acne symptoms. CoTrimoxazole is a popular choice for acne patients who have not responded to other types of antibiotics (eg. Doxycycline, Minocycline, Erythromycin).

Trimethoprim Images

Tobramycin

Combination Tobramycin and Dexamethasone Ointment (Nebracin)

Tobramycin (Tobrex) is an antibiotic in the Aminoglycoside family. It is used topically to treat certain kinds of bacterial infections of the skin and eye.

Tobramycin is rarely used as a treatment for acne. Tobramycin has minimal activity against most gram-positive bacteria, a group which includes the acne-causing P. acnes bacterium. Laboratory testing has consistently confirmed that P. acnes bacteria are highly resistant to members of the Aminoglycoside antibiotic family. It is unlikely that Tobramycin will be an effective treatment for most individuals with acne.

Tobramycin Images

Thiamphenicol

Thiamphenicol (Biothicol) Capsules

Thiamphenicol (Biothicol) is an antibiotic in the Amphenicol family. It is primarily used to treat certain types of urinary tract and sexually transmitted bacterial infections.

Thiamphenicol is rarely used for the treatment of acne. Thiamphenicol is not approved for human use in all countries, but it is widely used in other countries.

Laboratory testing indicates that acne-causing Propionibacterium acnes bacteria are moderately susceptible to Thiamphenicol, as well as it’s closely-related cousin Chloramphenicol. High-level antibiotic resistance to to Thiamphenicol among P. acnes bacteria is rare. There is also a small amount of clinical research that suggests Thiamphenicol can be an effective treatment for individuals with moderate to severe acne.

Additional research and patient reports are needed to determine the best role (if any) of Thiamphenicol in acne treatment regimens.

Thiamphenicol Images

Telithromycin

Telithromycin (Ketek) Tablets

Telithromycin (Ketek) is an antibiotic in the Macrolide family. It is primarily used to treat certain types of bacterial respiratory infections.

Telithromycin is rarely used as a treatment for acne symptoms. There have been some safety concerns about the effect that this antibiotic has on the liver. The use of this medication in the United States was curtailed in 2007, and it is not widely used and may not be available in all countries.

Telithromycin may be useful in the treatment of acne, but there is little clinical research about this application. Laboratory testing indicates that acne-causing Propionibacterium acnes bacteria tend to be susceptible to Macrolide family antibiotics, which includes Telithromycin. At least one study has reported that Telithromycin is substantially more toxic to P. acnes bacteria than other Macrolides that are commonly used for the treatment of acne (eg. Erythromycin, Azithromycin).

P. acnes bacteria that are resistant to Macrolide family antibiotics are becoming increasingly common in many places around the world. However, many of these antibiotic-resistant P. acnes bacteria may still be susceptible to Telithromycin because of its unique molecular features.

Telithromycin is an antibiotic that warrants further study into its utility as a treatment of acne vulgaris.

Telithromycin Images

Tedizolid

Tedizolid (Sivextro) 200mg Tablets

Tedizolid (Sivextro) is an antibiotic in the Oxazolidinone family. It is primarily used for the treatment of certain types of bacterial skin infections. Tedolizid is a relatively new antibiotic that is not yet widely used and may not be available in all countries.

Tedolizid is rarely used as a treatment for acne. There is very little clinical research or laboratory testing on the effectiveness of Tedolizid for the treatment of acne. It is not currently marketed as an acne treatment. However, laboratory testing has shown that Tedizolid does have activity against many gram-positive bacteria, a group that includes the acne-causing P. acnes bacterium.

Tedizolid is an antibiotic that warrants further investigation into its utility as an acne treatment. Because this medication is not available in generic form, it will likely be substantially more expensive than many alternative antibiotics.

Tedizolid Images

Sulfathiazole

Sulfatiazol Ointment

Sulfathiazole (Sulfatiazol) is an antibiotic in the Sulfonamide family. It is used as a topical antibacterial to prevent and treat bacterial infections of the skin.

Sulfathiazole is occasionally used as a topical treatment for acne. This medication is often combined with other antibiotics (eg. Penicillin, Trimethoprim) in topical antibacterial ointments.

There is limited clinical or laboratory research into the effectiveness of Sulfathiazole for the treatment of acne symptoms. However, laboratory testing does indicate that the acne-causing P. acnes bacterium tends to moderately susceptible to antibiotics in the Sulfonamide family, such as Sulfathiazole.

Topical ointments that combine Sulfathiazole with a complementary antibiotic (eg. Penicillin G) are more likely to be effective at improving acne symptoms than Sulfathiazole alone. Topical Sulfathiazole may better control acne symptoms when be combined with complementary therapies.

A very old medical report (1951) suggested that direct injection of a Sulfathiazole solution into inflammatory acne cysts was an effective treatment, but this approach has not been widely practiced. Other members of the Sulfonamide family (eg. Dapsone, Silver Sulfadiazine, Sulfacetamide) are more commonly used as topical treatments for acne.

Sulfathiazole Images

Sulfamethoxazole

Combination Sulfamethoxazole and Trimethoprim (Bactropin) Tablets

Sulfamethoxazole (SMX) is an antibiotic in the Sulfonamide family. It is used to treat certain types of respiratory tract, urinary tract and skin infections that are caused by bacteria. Sulfamethoxazole is rarely used alone. It is primarily available in combination with another antibiotic called Trimethoprim. This combination is called Co-Trimoxazole, and it is a very common antibiotic.

Sulfamethoxazole is rarely used by itself as a treatment for acne. However, Co-Trimoxazole is a popular treatment for moderate to severe acne symptoms. Both clinical research and laboratory testing indicates that Co-Trimoxazole can be an excellent acne treatment, particularly for individuals with inflammatory acne symptoms.

Laboratory testing has indicated that the acne-causing P. acnes bacteria is moderately susceptible to Sulfamethoxazole. P. acnes bacteria are also moderately susceptible to Trimethoprim. These two antibiotics are synergistic, and the combination is substantially more toxic to P. acnes bacteria.

Sulfamethoxazole Images

Sulfafurazole

Sulfisoxazole Molecule

Sulfafurazole (Sulfisoxazole) is an antibiotic in the Sulfonamide family. It is a short-lived antibiotic that is active against certain types of gram-positive and gram-negative bacteria. This medication is not available in all countries and it is not a commonly used medication.

Sulfisoxazole is rarely used to treat acne. For the treatment of active acne symptoms, other Sulfonamide family antibiotic (eg. Sulfamethoxazole, Dapsone, Silver Sulfadiazine) are much more commonly used.

Sulfisoxazole may be available in oral and topical formulations.

Sulfisoxazole Images