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Antibiotic Resistance in Acne Treatment. Clinical Question: What is the evidence for antibiotic resistance in acne, and how does resistance affect treatment? Bottom Line: Use of topical and systemic antibiotics for acne is associated with formation of resistance in Propionibacterium acnes and other bacteria, with clinical consequences. Guidelines recommend resistance reduction strategies including avoidance of antibiotic monotherapy, combination treatment with topical modalities, and limiting the duration of oral antibiotic use.