Table 4. Selected Oral Antibiotics for Acne
AgentFDA Pregnancy CategoryDosageNotes
ErythromycinB250–500 mg, 2–4 times/dayLong-term use in pregnancy has not been studied
    Bacterial resistance is diminished by combining with topical benzoyl peroxide
    Hepatotoxicity is associated with erythromycin estolate; not recommended for pregnancy
AzithromycinBDosing routine may vary, eg, 250 mg, 3 times/weekOff-label indication
    More flexible dosing regimen for less compliant patients
CephalexinB500 mg twice dailyConcern for Staphylococcus resistance
AmoxicillinB250–500 mg twice dailyUse in early pregnancy may increase risk of oral clefts
Trimethoprim/sulfamethoxazoleC160/800 mg twice per dayExposure during the first trimester is associated with miscarriage
TetracyclineD250–500 mg twice dailyToxic effects on fetal teeth and bone
    Avoid in pregnancy
Minocycline or doxycyclineD50–100 mgToxic effects on fetal teeth and bone
once or twice per dayAvoid in pregnancy
  • FDA, US Food and Drug Administration.