From the Guidelines
Seysara (sarecycline) is conditionally recommended over doxycycline for the treatment of moderate to severe acne vulgaris due to its more favorable side effect profile and once-daily dosing, as stated in the guidelines of care for the management of acne vulgaris 1. When managing acne with systemic medications, the choice between Seysara and doxycycline should be based on individual patient factors, including the severity of acne, patient preferences, and potential side effects.
- Seysara is typically prescribed at 60-150 mg once daily based on body weight (60 mg for 33-54 kg, 100 mg for 55-84 kg, 150 mg for 85-136 kg) 1.
- Doxycycline is usually given as 50-100 mg once or twice daily 1. Both medications should be taken for 12 weeks, with reassessment of efficacy at that point.
- Seysara has fewer gastrointestinal side effects than doxycycline and causes less photosensitivity, making it more tolerable for many patients 1.
- It also has a narrower spectrum of activity that specifically targets P. acnes bacteria while having less impact on normal gut flora, potentially reducing the risk of antibiotic resistance. However, doxycycline may be preferred in cases where cost is a significant concern, as it is available as a generic and typically less expensive. Both medications should be taken with a full glass of water, and patients should be advised to use sun protection while taking either antibiotic, though this is especially important with doxycycline. The guidelines recommend limiting the use of systemic antibiotics when possible to reduce the development of antibiotic resistance and other antibiotic-associated complications 1. Additionally, systemic antibiotics should be used concomitantly with benzoyl peroxide and other topical therapy to enhance efficacy and reduce the risk of resistance 1.
From the Research
Comparison of Seysara and Doxycycline for Acne Vulgaris
- Seysara (sarecycline) is a novel, narrow-spectrum tetracycline derivative approved for the treatment of inflammatory non-nodular moderate to severe acne vulgaris 2.
- Doxycycline is a broad-spectrum antibiotic commonly used to treat moderate to severe acne vulgaris 3.
Efficacy and Safety
- Sarecycline has demonstrated low propensity to resistance and is active against tetracycline-resistant Staphylococcus aureus as well as erythromycin- and clindamycin-resistant C. acnes strains 2.
- Doxycycline has been shown to be effective in the treatment of inflammatory acne, but its use is associated with a higher risk of resistance and side effects such as phototoxic reactions 3.
Treatment Recommendations
- For moderate to severe acne vulgaris, sarecycline may be a preferred treatment option due to its targeted antibacterial activity and lower risk of resistance and side effects 2.
- Doxycycline may still be considered as a treatment option, but its use should be carefully evaluated based on the patient's individual needs and medical history 3.