ObjectiveAntibiotics have been routinely used for several decades againstPropionibacterium acnes(P. acnes), but antibiotic resistance ofP. acnesis becoming a global problem. Only one related Chinese study is available. The aim of this study was to assess the antibiotic susceptibility ofP. acnesobtained from patients with acne in Southwest China.DesignThis was a prospective cross-sectional study. Cutaneous samples were obtained from acne lesions on the face of 375 patients. Samples were cultured in anaerobic medium to identify the presence ofP. acnes. Susceptibility tests of isolatedP. acneswere performed for tetracycline, doxycycline, clindamycin, erythromycin, azithromycin and clarithromycin using the Epsilometer test.ResultsP. acneswas isolated from 227 patients; 224 isolates (98.7%) were susceptible to doxycycline and 220 (96.9%) were susceptible to tetracycline, followed by clindamycin and clarithromycin in 101 (44.5%) and 102 (44.93%) isolates, respectively. Susceptibility ofP. acneswas detected for erythromycin in 96 (42.3%) patients, followed by azithromycin in 94 (41.4%). Subjects who received antibiotics (topical and oral) had higher frequencies of antibiotic-resistantP. acnesas well as increased antibiotic minimum inhibitory concentrations compared with patients without antibiotic treatment.ConclusionsP. acneswas highly sensitive to cyclines (doxycycline and tetracycline).P. acnesshowed higher resistance rates to macrolides–lincosamides–streptogramins antibiotics (such as erythromycin, azithromycin, clarithromycin and clindamycin). The irrational use of antibiotics for acne treatment is probably a problem in China and elsewhere. These results suggest that dermatologists should be more prudent in prescribing antibiotics for acne.