Omadacycline therapy for Mycobacterium abscessus species infections

Link to article at PubMed

Intern Med J. 2023 Mar 14. doi: 10.1111/imj.16071. Online ahead of print.


BACKGROUND: Antimicrobial resistance and therapy related adverse effects make Mycobacterium abscessus treatment challenging. Omadacycline is a novel, bioavailable aminomethylcycline with favourable in-vitro activity against M. abscessus.

AIMS: To describe a case report and review the published literature describing outcomes for M. abscessus infections treated with omadacycline.

METHODS: Systematic literature review.

RESULTS: We identified 3 articles, which, in addition to our case report, describe 18 patients. Pulmonary infections were most frequent. Minimum inhibitory concentrations were reported for two isolates (0.25 and 0.5 mg/L). Despite half the patients starting omadacycline due to failure of prior therapy, fifteen patients (83%) had a favourable outcome, defined as either "cure", "improvement" or "clinical success" as determined by the primary study authors. One patient (6%) discontinued omadacycline due to gastro-intestinal intolerance.

CONCLUSIONS: Although this limited observational data and in-vitro susceptibility results are encouraging, randomised control trials are required to determine the role of omadacycline as part of combination therapy for this most difficult to treat pathogen. This article is protected by copyright. All rights reserved.

PMID:36917124 | DOI:10.1111/imj.16071

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