Normally when I see a post like this, I can think of at least one obvious potential solution that the OP hasn’t tried yet, but you really have tried every almost every topical and drug that would normally be recommended for acne, except accutane. Of course you could also try out some less common actives, or different variations of the things you’ve already tried, like a different antifungal for example. I’m just not sure how likely that would be to give you a different outcome. Maybe it’s time to talk to your derm about laser or light treatments to hopefully make a bigger change in a shorter amount of time. If it works, hopefully you can use your current routine to maintain the results. I’m assuming you don’t want try accutane. That’s obviously also an option.