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Sarecycline is a narrow-spectrum, third-generation tetracycline-class antibiotic specifically engineered for the treatment of inflammatory lesions associated with moderate to severe acne vulgaris. Developed by Paratek Pharmaceuticals and licensed to Almirall and Allergan (now AbbVie), it received FDA approval in 2018. Sarecycline distinguishes itself from older tetracyclines, such as doxycycline and minocycline, by its targeted activity against *Cutibacterium acnes* and its significantly reduced potency against Gram-negative enteric bacteria, which potentially minimizes disruption to the intestinal microbiome. Its mechanism of action involves binding to the A-site of the bacterial 30S ribosomal subunit, thereby inhibiting protein synthesis and exerting an anti-inflammatory effect.
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