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Because some people love to crap on natural regimens, and others like to get smart with the formula, add azelaic, keto and the kitchen sink when in my experience they counteract eachother. I've said it over and over, the more you deviate from the original formula, the less likely you'll have success. This is based on my experience over the past 15 years, having tried keto and the like and even using the wrong type of zinc (mono vs hepta).
Again it's not to say my formula is the ultimate end, but start at the base, make sure it works at its core, and evaluate for 6 months. If you want to experiment after, go right on ahead, but dont say zix doesnt work when you've been using a ton of other treatments which may negate the original formula. It's just common sense.