A matched pilot cohort study of intravenous omadacycline in the treatment of severe pneumonia associated with carbapenem-resistant Acinetobacter baumannii
Abstract
Background Carbapenem-resistant Acinetobacter baumannii (CRAB)-caused severe pneumonia is associated with high mortality rates, and treatment options are limited. Tetracyclines, including tigecycline and omadacycline, have in vitro activity against CRAB. We conducted this study to explore the efficacy of omadacycline in CRAB-caused severe pneumonia. Methods This retrospective cohort study was performed by collecting data on severe CRAB-caused pneumonia cases treated with omadacycline or tigecycline at Nanjing Drum Tower Hospital from January 2022 to June 2024. A 1:1 propensity score-based matching design based on baseline characteristics was utilized. We compared the incidence of clinical response at day 14 or at the end of treatment (EOT) and other clinical outcomes between the two cohorts. Results A total of 40 patients were analyzed, with 20 patients in each cohort. The clinical success rate at day 14 or at the EOT was 65% (13/20) in the omadacycline group compared to 55% (11/20) in the tigecycline group. Both groups had an equal mortality rate, with 8 patients dying within 28 days. Development of tigecycline resistance was observed in one patient. The average duration of invasive mechanical ventilation, vasopressor, renal replacement therapy was also comparable in both groups. Adverse events occurred in 50% (10/20) of patients in the omadacycline group and 75% (15/20) in the tigecycline group, with coagulopathy being significantly lower in the omadacycline group (1/20,…
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: 40 participants or records.
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