Omadacycline in the treatment of diverse bacterial infections: A retrospective analysis of clinical outcomes and adverse events
- 1Department of Pharmacy, Hunan Provincial People’s Hospital and The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, 410005, China
- 2Department of Pharmacy, the Second Xiangya Hospital, Central South University, Changsha, 410011, China
- 3Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, 410078, China; Hunan key laboratory of the research and development of novel pharmaceutical preparations, Changsha Medical University, Changsha, 410219, China
Abstract
Purpose: 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. Methods: 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. Results: 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). Conclusion: 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.
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BibTeX
@article{qin2026omadacycline,
title = {{Omadacycline in the treatment of diverse bacterial infections: A retrospective analysis of clinical outcomes and adverse events}},
author = {Wen-Jie Qin and Ye-Lei Zhao and Zhi-Ling Yang and Li Chen and Rui-Hui Ou and Qiang Qu and Yi-Ming Wang and Yan-Tao Zhang and Jian Qu},
journal = {Journal of Infection and Public Health},
year = {2026},
month = oct,
doi = {10.1016/j.jiph.2026.103387},
url = {https://doi.org/10.1016/j.jiph.2026.103387},
note = {CC BY},
}
RIS
TY - JOUR
TI - Omadacycline in the treatment of diverse bacterial infections: A retrospective analysis of clinical outcomes and adverse events
AU - Wen-Jie Qin
AU - Ye-Lei Zhao
AU - Zhi-Ling Yang
AU - Li Chen
AU - Rui-Hui Ou
AU - Qiang Qu
AU - Yi-Ming Wang
AU - Yan-Tao Zhang
AU - Jian Qu
PY - 2026
DA - 2026/10/30
JO - Journal of Infection and Public Health
DO - 10.1016/j.jiph.2026.103387
UR - https://doi.org/10.1016/j.jiph.2026.103387
AB - Purpose: 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. Methods: 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. Results: 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). Conclusion: 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.
SN - 1876-0341
SN - 1876-035X
ER -