Sarecycline for moderate to severe acne: a promising narrow-spectrum antibacterial drug.

Sarecycline, a narrow-spectrum antibacterial drug approved by the FDA in 2018, targets Cutibacterium acnes while potentially minimizing disruption to the gut microbiota. The aim of this study is to assess the efficacy and safety of sarecycline compared to placebo in treating moderate to severe facial acne. A comprehensive search of PubMed, MEDLINE, and Cochrane databases was performed, with data extraction and screening conducted independently by two authors. Statistical analysis used RevMan, and the risk of bias was evaluated using RoB 2. Three RCTs (n = 2287 patients, mean age 19.6-20.8 years) met the inclusion criteria. Sarecycline (1.5 mg/kg) administered daily for 12 weeks significantly reduced inflammatory and non-inflammatory lesion counts compared to placebo (p < 0.00001). Other outcomes were not statistically significant. Sarecycline 1.5 mg/kg daily is an effective and well-tolerated treatment for moderate to severe acne with minimal side effects.