Accutane has many potential side effects but this must be balanced against the fact that it provides the best chance of long term remission from acne. However, as your son may outgrow his tendancy for acne as adolesence passes, I agree this should be considered only if his acne continues after other treatments have been fully explored.
Which antibiotic and creams has he tried? Erythromycin has a high resistance rate and oxytetracycline is usually preferable. If this fails, Lymecycline should be considered.
The best topical lotion in my opinion is Differin. It can be as effective as topical Isotretinoin but is usually much better tolerated, with little or no redness and peeling.
It is even more effective when used in conjunction with oral antibiotics.
I have taken Accutane twice (20% of patients require a second course) with good results, please see my photos in my profile. I am happy to discuss any concerns you have about this drug.
Eloise.