Sarecycline: a narrow spectrum tetracycline for the treatment of moderate-to-severe acne vulgaris

Future Microbiol. 2019 Sep;14(14):1235-1242. doi: 10.2217/fmb-2019-0199. Epub 2019 Sep 2.


Sarecycline is a novel, narrow-spectrum, once-daily tetracycline-derived oral antibiotic that is FDA-approved in the US to be taken with or without food for moderate-to-severe acne vulgaris for ages 9 years of age and older. Sarecycline possesses anti-inflammatory properties and potent activity against Gram-positive bacteria, including activity against multiple strains of Cutibacterium acnes, while exhibiting minimal activity against enteric aerobic Gram-negative bacteria. Unlike many acne studies, sarecycline was investigated for chest and back acne. Significant reduction in inflammatory lesions was seen at week 12 at 1.5 mg/kg/day of sarecycline, with statistically significant improvement seen as early as week 3. No reports of phototoxicity, dizziness, pseudotumor cerebri or lupus but 1.2% nausea and 1.2% vaginal candidiasis was reported in the pivotal Phase III studies.

Keywords: acne; antibiotics; microbiota; narrow spectrum; sarecycline; tetracycline.

Publication types

  • Review

MeSH terms

  • Acne Vulgaris / drug therapy*
  • Acne Vulgaris / microbiology
  • Anti-Bacterial Agents / therapeutic use*
  • Anti-Inflammatory Agents / therapeutic use
  • Bacteria / drug effects*
  • Clinical Trials, Phase III as Topic
  • Gram-Negative Aerobic Bacteria / drug effects
  • Gram-Positive Bacteria / drug effects
  • Humans
  • Microbial Sensitivity Tests
  • Propionibacteriaceae / drug effects
  • Tetracyclines / therapeutic use*


  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents
  • Tetracyclines
  • sarecycline

Supplementary concepts

  • Cutibacterium acnes subsp. acnes