1
|
Mingora CM, Bullington W, Faasuamalie PE, Levin A, Porter G, Stadnik R, Varley CD, Addrizzo-Harris D, Daley CL, Olivier KN, Winthrop KL, Dorman SE, Flume PA. Long-term Safety and Tolerability of Omadacycline for the Treatment of Mycobacterium abscessus Infections. Open Forum Infect Dis 2023; 10:ofad335. [PMID: 37476076 PMCID: PMC10354853 DOI: 10.1093/ofid/ofad335] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 06/29/2023] [Indexed: 07/22/2023] Open
Abstract
Background Mycobacterium abscessus is a virulent human pathogen. Treatment is complex and often poorly tolerated with suboptimal rates of eradication, highlighting the need for improved therapeutics. This study reports clinical experience with omadacycline for treatment of M abscessus infections at five large nontuberculous mycobacterial (NTM) disease clinics across the United States to better understand long-term safety and tolerability. Methods We conducted a multicenter retrospective chart review of adults with M abscessus infections. All patients treated with omadacycline as part of a multidrug therapeutic regimen through December 2021 were included. Clinical data from time of omadacycline initiation and up to 12 months of follow-up were collected. Descriptive statistics were performed. Results Analysis included 117 patients. Among patients with M abscessus isolate subspeciation, 58 of 71 (81.7%) were M abscessus spp abscessus. In isolates with reported drug susceptibility testing, 15 of 70 (21.4%) had confirmed susceptibility to macrolides. The most common site of infection was lungs. Median duration omadacycline treatment was 8 months (range, 0.25-33 months; interquartile range, 4-15 months). Omadacycline was discontinued in 60 patients (51.3%); 20 completed planned treatment course, 23 experienced intolerance or adverse event leading to drug cessation, and 17 stopped due to cost, death (unrelated to NTM infection or therapy), or another reason. In those with pulmonary disease, 44 of 95 (46%) had 1 or more negative cultures at time of final microbiological assessment, with 17 of 95 (18%) achieving culture conversion. Conclusions This study reports data supporting long-term safety and tolerability of omadacycline along with signal of effectiveness in treatment of M abscessus infections.
Collapse
Affiliation(s)
| | - Wendy Bullington
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Paige E Faasuamalie
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Adrah Levin
- National Jewish Health and University of Colorado School of Medicine,Denver, Colorado, USA
| | - Gabriella Porter
- New York University Grossman School of Medicine, New York, New York, USA
| | - Ryan Stadnik
- Oregon Health & Science University, Portland, Oregon, USA
| | - Cara D Varley
- Oregon Health & Science University, Portland, Oregon, USA
| | | | - Charles L Daley
- National Jewish Health and University of Colorado School of Medicine,Denver, Colorado, USA
| | - Kenneth N Olivier
- Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Susan E Dorman
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Patrick A Flume
- Medical University of South Carolina, Charleston, South Carolina, USA
| |
Collapse
|