Health Articles | March 27, 2007 Some call it the �acne antibiotic game�. First comes tetracycline, then comes doxycycline, and then your doctor finally recommends erythromycin. But what do you do when these common antibiotics fail to control your acne outbreaks? Well typically, your dermatologist might suggest isotretinoin- the ultimate prescription acne drug. But why is isotretinoin the final pharmaceutical answer for acne? It's probably because excessive or inappropriate usage of antibiotics could lead to gram-negative folliculitis. Gram-negative folliculitis is caused by bacterial interference, and replacement of the gram-positive bacteria on the face and within the mucous membranes of the nose, with gram-negative bacteria. And while acne is readily diagnosed, according to a study in the American Journal of Clinical Dermatology, incidences of gram-negative folliculitis are probably underestimated in patients with re-occurring and difficult to treat acne. Even though isotretinoi...