I went into a new dermotolgist office for my adult cystic acne. I mostly get acne on the jawline, upper neck, sides of face.

I've been on ampicillin and tretinoin (retinoid) before for a couple of months. The ampicillin did wonders but now I feel I shouldn't take any antibiotics because of stomach issues. I don't want to kill off any more good backterial. I tried continuing the tretinoin after I weened myself off of ampicillin and it just caused more break outs - this time more cystic. I'm not sure if it was me coming off of antibiotics, or the retinoid not working for me.

This new dermatologist prescribed me a toner Omnicef mixed with witch hazel. I was instructed to break sixteen 300 mg capsuls and mix it with 16 oz of witch hazel. I'm supposed to apply this on my face as a toner in the morning and night after I wash my face with a gentle face wash Cerave.

She also prescribed me epiduo to put on at night.

I cannot find anything on Omnicef and have a few questions before I buy the prescriptions:

1. Anybody have experience with using omnicef mixed with witch hazel as a toner that can give insights to its effectiveness just as a topical toner? I don't want to take antibiotics orally.

2. Will omnicef + witch hazel give me an initial breakout? I know epiduo may do that so I am holding off on using that. Retinoids I've used before didn't do well for my under the skin acne.

3. Will applying an antibiotic topically, instead of orally, still ruin my liver/gut bacteria?

Any insight would help. Thanks.