Morrisette, TaylorAlosaimy, SaraLagnf, Abdalhamid M.Philley, Julie V.Sigler, CarlyButt, SairaKaip, Emily A.MacDougall, ConanMejia-Chew, CarlosBouchard, JeannetteFrens, Jeremy J.Gore, TristanHamad, YasirHoward, CatessaBarger, MelissaCabanilla, M. GabrielaOng, AaronVeve, Michael P.Webb, Andrew J.Stevens, Ryan W.Cohen, Keira A.Rybak, Michael J.2023-04-182023-04-182021-12-04Morrisette T, Alosaimy S, Lagnf AM, et al. 1082. Real-World Experience with Omadacycline for Nontuberculous Mycobacterial Infections: A Multicenter Evaluation. Open Forum Infect Dis. 2021;8(Suppl 1):S632-S633. Published 2021 Dec 4. doi:10.1093/ofid/ofab466.1276https://hdl.handle.net/1805/32483Background: Nontuberculous mycobacteria (NTM) are resistant to numerous antibiotics and lead to significant morbidity and mortality. Omadacycline (OMC) is an aminomethylcycline antibiotic that is Food and Drug Administration-approved for acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia. Furthermore, OMC has shown in vitro activity against NTM. Given that real-world evidence is lacking, our primary objective was to evaluate the clinical success and tolerability of OMC when used for a variety of NTM infections. Methods: This was a multicenter, retrospective, observational study conducted from January 2020 to June 2021. We included all patients ≥ 18 years of age that received OMC of any indication for Mycobacterium spp. The primary outcome was clinical success, defined as a lack of all-cause mortality, lack of persistence or re-emergence of infection during or after therapy, and lack of alteration of OMC. Incidence of adverse effects potentially attributable to OMC and reasons for OMC utilization were also analyzed. Results: A total of 31 patients were included from 12 geographically distinct academic health systems (median age: 57 (IQR, 45-63) years; 45% male; 81% Caucasian). The majority of isolated pathogens were Mycobacterium abscessus complex (84%) and of those with subspeciation performed (54%), the majority (86%) were subsp. abscessus. The primary infections were of pulmonary origin (67%) and the median (IQR) duration of OMC therapy was 5.3 (3.2-9.4) months. Most isolates did not have OMC susceptibility conducted (87%), while the majority did for tigecycline (90%). Clinical success was reported in 81% of the population. Most patients were on combination antimicrobial therapy, and 39% of patients reported an adverse effect while on OMC (58% gastrointestinal distress). The majority of patients were prescribed OMC due to ease of administration (61%) and antimicrobial resistance to previous antibiotics (42%). Conclusion: OMC may be a potential option for the therapy of NTM infections. Prospective, randomized clinical trials are needed to confirm our preliminary findings.en-USAttribution 4.0 InternationalAntibioticsLungBacterial pneumoniaNontuberculous mycobacteriaDrug resistanceMycobacterium infectionsPathogenic organismOmadacyclineArticle