Faculty, Staff and Student Publications

Language

English

Publication Date

10-18-2023

Journal

Antimicrobial Agents and Chemotherapy

DOI

10.1128/aac.00824-23

PMID

37768312

PMCID

PMC10583686

PubMedCentral® Posted Date

9-28-2023

PubMedCentral® Full Text Version

Post-print

Abstract

Infections due to nontuberculous mycobacteria (NTM) continue to increase in prevalence, leading to problematic clinical outcomes. Omadacycline (OMC) is an aminomethylcycline antibiotic with FDA orphan drug and fast-track designations for pulmonary NTM infections, including Mycobacteroides abscessus (MAB). This multicenter retrospective study across 16 U.S. medical institutions from January 2020 to March 2023 examined the long-term clinical success, safety, and tolerability of OMC for NTM infections. The cohort included patients aged ≥18 yr, who were clinically evaluable, and` had been treated with OMC for ≥3 mo without a previous diagnosis of cystic fibrosis. The primary outcome was 3 mo clinical success, with secondary outcomes including clinical improvement and mortality at 6- and 12 mo, persistence or reemergence of infection, adverse effects, and reasons for OMC utilization. Seventy-five patients were included in this analysis. Most patients were female (48/75, 64.0%) or Caucasian (58/75, 77.3%), with a median (IQR) age of 59 yr (49–67). Most had NTM pulmonary disease (33/75, 44.0%), skin and soft tissue disease (19/75, 25.3%), or osteomyelitis (10/75, 13.3%), and Mycobacterium abscessus (60/75, 80%) was the most commonly isolated NTM pathogen. The median (IQR) treatment duration was 6 mo (4 – 14), and the most commonly co-administered antibiotic was azithromycin (33/70, 47.1%). Three-month clinical success was observed in 80.0% (60/75) of patients, and AEs attributable to OMC occurred in 32.0% (24/75) of patients, leading to drug discontinuation in 9.3% (7/75).

Keywords

Humans, Female, Male, Retrospective Studies, Mycobacterium Infections, Nontuberculous, Nontuberculous Mycobacteria, Cystic Fibrosis, Mycobacterium abscessus, Anti-Bacterial Agents, Outcome Assessment, Health Care, Tetracyclines, omadacycline, nontuberculous mycobacteria, Mycobacterium abscessus, culture conversion

Published Open-Access

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