Efficacy and safety of Omadacycline in community-acquired pneumonia among elderly patients: a real-world evidence study
Abstract
Objective This study aimed to evaluate real-world effectiveness and safety of omadacycline for elderly community-acquired pneumonia (CAP) versus tigecycline, moxifloxacin, and cefoperazone-sulbactam after inverse probability of treatment weighting (IPTW). Methods This single-center retrospective cohort study enrolled non-ICU hospitalized elderly CAP patients. Missing covariates were handled by multiple imputation, and IPTW balanced groups. Primary outcome was pragmatic clinical response (improvement in at least one of laboratory markers, chest imaging, or clinical symptoms), with a sensitivity analysis requiring all three. Secondary outcomes included hospital stay, antibiotic duration, microbiological clearance, and adverse events. Subgroup analyses used age < 75 vs ≥ 75 years and CURB-65 < 2 vs ≥ 2. Results A total of 1,208 patients were included: 177 in the omadacycline group, 124 in the tigecycline group, 666 in the moxifloxacin group, and 241 in the cefoperazone-sulbactam group. After IPTW adjustment, omadacycline showed a pragmatic clinical response comparable to tigecycline, higher than moxifloxacin, but lower than cefoperazone-sulbactam. Omadacycline was associated with shorter hospital stay than tigecycline and cefoperazone-sulbactam, but longer than moxifloxacin; antibiotic duration was comparable to tigecycline, shorter than cefoperazone-sulbactam, but longer than moxifloxacin. Microbiological clearance was lower with omadacycline in the evaluable subset, whereas…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,208 participants or records.
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