Multicenter Real-World Outpatient Use of Intravenous Omadacycline

Abstract Introduction Omadacycline is indicated for the treatment of acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia. With limited real-world data, we report the clinical experience and outcomes of intravenous (IV) omadacycline in outpatient settings for treatment of any infection. Methods We conducted a multicenter, retrospective review of adults who received IV omadacycline for any infection between April 2019 and November 2022. Clinical data included infection type, microbiology, therapy characteristics, and adverse events. Clinical success was defined as complete or partial symptom resolution at the completion of IV omadacycline. Recurrence data at 12 months were assessed for patients with bone and joint infections (BJI). Results The study included 67 patients (median age, 59 years; 56.7% male; median Charlson index, 4) from 17 infectious disease office infusion centers. Most had BJI (53.7%), followed by complicated skin and skin structure infections (29.8%), complicated intra-abdominal infections (7.5%), respiratory tract infections (7.5%), and urinary tract infections (1.5%). The most common Gram-positive pathogen was methicillin-resistant Staphylococcus aureus (14.2%), and the most common Gram-negative pathogen was Enterobacter spp. (7.5%). Nontuberculous mycobacteria were identified in nine patients. Clinical success occurred in 86.9% of evaluable patients. Non-success was due to persistent infection (6.7%), adverse events (3.3%), and resistant pathogens (1.7%). Patients with BJI had sustained clinical success at 12 months in 72.4%. Conclusions Omadacycline was shown to be safe and effective when used as IV therapy in the outpatient setting to treat a variety of serious infections, including bone and joint infections, and mycobacterial infections.