1 doctor weighed in:

I am a female, 40's, taking 250 mg of cephalexin for over 5 years 1x daily for cystic acne with probiotic. Should i be concerned with long term use?

1 doctor weighed in
Dr. Pavel Conovalciuc
Family Medicine

In brief: I would

Antibiotics tend to lose effectiveness with time due to bacteria developing resistance to it.
You don't mention how effective it's been for you, so more information in that direction may be helpful as well. Probiotic supplement is a must with the use of antibiotic, whether short or long term, but you may ask your derm doc if there are other options available in this day and age.

In brief: I would

Antibiotics tend to lose effectiveness with time due to bacteria developing resistance to it.
You don't mention how effective it's been for you, so more information in that direction may be helpful as well. Probiotic supplement is a must with the use of antibiotic, whether short or long term, but you may ask your derm doc if there are other options available in this day and age.
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