1290 - Real-World Experience with Omadacycline for Nontuberculous Mycobacterial and Gram-Negative Infections: A Multicenter Evaluation

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Presenting Author(s)

Taylor Morrisette

Assistant Professor
Medical University of South Carolina College of Pharmacy
Charleston, South Carolina
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

JP

Julie Philley

Physician
University of Texas at Tyler
Tyler, Texas
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CS

Carly Sigler

Research Assistant
The University of Texas Health Science Center
Tyler, Texas
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Jeremy J. Frens

Antimicrobial Stewardship Coordinator
Cone Health
GREENSBORO, North Carolina
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AW

Andrew J. Webb

Pharmacy Resident
Mayo Clinic
Rochester, Minnesota
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Ryan W. W. Stevens

Clinical Pharmacist
Mayo Clinic
Rochester, MN
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Catessa A. Howard

Lead Clinical Pharmacy Specialist - Antimicrobial Stewardship
West Virginia University Medicine
Morgantown, West Virginia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JB

Jeannette Bouchard

Pharmacy Fellow
University of South Carolina
Columbia, SC
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
PB

P B. Bookstaver

Associate Professor
The University of South Carolina College of Pharmacy
Columbia, South Carolina
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
MB

Melissa Barger

Physician
Ventura County Medical Center
Ventura, California
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AL

Abdalhamid M. Lagnf

Research Assistant
Anti-Infective Research Laboratory; Wayne State University
Detroit, Michigan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Sara Allosaimy

Research Scientist
Wayne State
Detroit, Michigan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
MR

Michael J. Rybak

Professor
Eugene Applebaum College of Pharmacy and Health Sciences
Detroit, Michigan
Disclosure: Paratek (Grant/Research Support)

Background: Omadacycline (OMC) is an aminomethylcycline antibiotic in the tetracycline class that has been Food and Drug Administration-approved for acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia. OMC has been shown to have potent in vitro activity against a broad-spectrum of Gram-positive and Gram-negative organisms, as well as Nontuberculous Mycobacteria (NTM). Due to it’s unique activity and availability as an oral agent, off-label use of OMC has been increasing. We evaluated the real-world effectiveness and safety of OMC for a variety of infections.

Methods: This was a multicenter, retrospective, observational study that was conducted from January 2020 to June 2020. We included all patients ≥ 18 years of age that received OMC for ≥ 72 hours for any indication and/or pathogen. The primary outcome was clinical success, defined as a lack of 30-day (non-NTM) or 90-day (NTM) mortality or microbiologic recurrence and absence of therapy escalation or alteration. Reasons for OMC utilization and incidence of potential adverse effects attributable to OMC were also analyzed.

Results: A total of 18 patients were included from six geographically distinct academic health systems (median age: 56 (IQR, 49-60.5) years; 61% male; 72% Caucasian). The majority of OMC use was in NTM (61%; 100% Mycobacterium abscessus) and in Acinetobacter baumannii (22%) for bone/joint (39%) and respiratory tract (33%) infections. OMC was used primarily in the outpatient setting alone (83%) and most isolates did not have OMC susceptibility conducted (89%). Clinical success was reported in 83% of the total population (71% non-NTM and 91% NTM). The majority of patients were prescribed OMC due to antimicrobial resistance to previous antibiotic(s) (61%) and/or due to OMC’s availability as an oral agent (44%). Three patients experienced side effects while on therapy (serum creatinine elevation, AST/ALT increase, and gastrointestinal distress).

Conclusion: OMC appears to be effective and well-tolerated for a variety of infections caused by various pathogens, including M. abscessus and A. baumannii.