What question did this study set out to answer?

The study evaluates the safety and effectiveness of omadacycline for treating infections caused by carbapenem-resistant organisms in critically ill patients.

April 27, 2026Open Access

Clinical Outcomes of Omadacycline in Critically Ill Patients Treated for Carbapenem-Resistant Organism Infections: A Retrospective Study

Key Points

The study evaluates the safety and effectiveness of omadacycline for treating infections caused by carbapenem-resistant organisms in critically ill patients.
Retrospective analysis of patients ≥18 years with CRO-positive cultures treated with omadacycline for ≥72 hours.
Collected data included comorbidities and markers of disease progression, with a primary focus on 30-day all-cause mortality.
Secondary outcomes assessed were recurrence of infection, symptom resolution, readmission rates, and adverse events.
Among 132 patients, the overall 30-day mortality rate was 27.3%.
In the CRAB cohort (n=89), the mortality rate was 29.2% (26/89), and in the CRKP cohort (n=57), it was 29.8% (17/57).
Common adverse events included elevated liver enzymes and blood urea nitrogen levels, affecting 18% to 25% of patients.

Abstract

Objective: This study aimed to evaluate the efficacy and safety of omadacycline (OMA) for the treatment of carbapenem-resistant organisms (CROs) infections, which are associated with substantial morbidity and mortality and limited therapeutic options. Methods: The patients included were ≥ 18 years old, had CRO-positive cultures, and had been treated with OMA-based combination therapy for ≥ 72 hours. Common clinical comorbidities and markers of disease progression were collected. The primary outcome was 30-day all-cause mortality. The secondary outcomes included 30-day recurrence, resolution of signs and symptoms of infection, 90-day readmission, and OMA-possible adverse events. Results: This study included 132 patients treated with OMA for CRO infections, with a median age of 67 years and a majority of male patients. Of the 132 patients analyzed, 78.8% were admitted to the intensive care unit, with hypertension, diabetes, and chronic pulmonary disease being the most frequent comorbidities. The median Charlson Comorbidity Index (CCI) score for the entire cohort was 5 (interquartile range IQR, 4– 7), indicating a moderate to high comorbidity burden. Pneumonia represented the predominant infection (84.8%). The overall 30-day mortality rate was 27.3%. In the Carbapenem-Resistant Acinetobacter baumannii (CRAB) cohort (n=89), OMA therapy was initiated promptly following culture confirmation, with a median treatment duration of 8 days. The 30-day mortality rate in this subgroup was 29.2% (26/89). Adverse events included elevated aspartate transaminase (21.3%, 19/89), alanine aminotransferase (18.0%, 16/89), alkaline phosphatase (23.6%, 21/89), blood urea nitrogen (25.8%, 23/89) and decreased fibrinogen levels (18.0%, 16/89). In the Carbapenem-Resistant Klebsiella pneumoniae (CRKP) cohort (n=57), the 30-day mortality rate was 29.8% (17/57), with a safety profile comparable to the CRAB group. Conclusion: The results demonstrated that OMA has promising clinical efficacy against CRAB or CRKP infections in critically ill patients. Infographic on CRO infections, study cohort and key outcomes. Keywords: omadacycline, Carbapenem-resistant Acinetobacter baumannii , carbapenem-resistant Klebsiella pneumoniae , tetracycline

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Cite This Study

Chen et al. (Wed,) studied this question.

synapsesocial.com/papers/69eefcf4fede9185760d3b0d https://doi.org/https://doi.org/10.2147/idr.s582186

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