Omadacycline in the treatment of diverse bacterial infections: A retrospective analysis of clinical outcomes and adverse events.

Authors

Wen-Jie Qin, Ye-Lei Zhao, Zhi-Ling Yang, Li Chen, Rui-Hui Ou, Qiang Qu, Yi-Ming Wang, Yan-Tao Zhang, Jian Qu

Published in

Journal of infection and public health. Volume 19. Issue 12. Pages 103387. Oct 17, 2026. Epub Oct 17, 2026.

Abstract

Omadacycline, a novel aminomethylcycline antibiotic approved for community-acquired bacterial infections, lacks comprehensive real-world evidence regarding its safety and effectiveness. This study aimed to evaluate the clinical outcomes and adverse events associated with omadacycline utilization.
We conducted a retrospective cohort study of inpatients administered omadacycline at *********************************** between January 2023 and June 2025. Effectiveness was assessed using chi-squared tests and Mann-Whitney U tests, while factors predictive of adverse drug reactions were identified by multivariable logistic regression.
Among 717 enrolled patients, treatment success was achieved in 490 (68.3%), including 110 (15.3%) with complete improvement and 380 (53.0%) with partial improvement. Treatment failure, comprising stable disease and deterioration, was observed in 25.1% and 6.6% of patients, respectively. The empirical treatment group had an effectiveness rate of 69.1%. The targeted therapy group had an effectiveness rate of 66.7%. All-cause mortality was 3.3% (n = 24). Of these, 75% (n = 18) died of bacterial infections. The overall microbial clearance rate was 49.7% (338/680). Eradication rates varied across specific bacterial subgroups. The highest clearance rate was observed for Haemophilus influenzae at 63.2%. Ten types of adverse reactions were documented. The most common were transaminase elevation (30.8%; n = 221), hepatic impairment (22.3%; n = 160), nausea/vomiting (5.4%; n = 39), diarrhea (3.9%; n = 28), and rash (2.8%; n = 20).
Omadacycline demonstrates clinically acceptable effectiveness against a variety of bacterial infections, including those caused by drug-resistant pathogens. It has therefore become an important clinical option, particularly for critically ill patients, offering new therapeutic approaches. However, given the occurrence of hepatic adverse events, close monitoring of liver function during treatment is recommended. This is especially important for patients with pre-existing liver disease, for whom appropriate drug selection and dose adjustment are critical.

PMID:
42913057
Bibliographic data and abstract were imported from PubMed on 24 Oct 2026.

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