Clinical outcomes and safety of eravacycline in hematology: a multicenter, real-world study

Hematology patients are highly susceptible to severe bacterial infections, particularly those caused by multidrug-resistant (MDR) gram-negative pathogens, which are associated with significant morbidity and mortality. Eravacycline, a novel fluorocycline antibiotic, demonstrates broad-spectrum activity against MDR bacteria. This real-world study aimed to evaluate the effectiveness and safety of eravacycline in Chinese hematology patients. In this multicenter, retrospective study, hematology patients receiving ≥3 days of eravacycline between September 2023 and September 2024 were included. The outcomes included clinical response rate, microbiological response rate, and safety. Of 796 patients included, most had hematological diseases (94.6%) and recent chemotherapy or radiotherapy (80.2%). The most common infection was pneumonia (57.4%), and sputum (47.2%) was the most frequent specimen type for pathogen isolation. Among 481 patients with microbiological examination results, <i>Klebsiella pneumoniae</i> (30.5%) and <i>Acinetobacter baumannii</i> (17.4%) were predominant. The mean time to defervescence was 3.2 ± 2.1 days. The overall clinical response rate was 88.8%, with response rates of 84.0% in bloodstream infections and 87.5% in pulmonary infections. Microbiological response rate at the end of treatment was 90.7%. Eravacycline exhibited high susceptibility rates across <i>A. baumannii</i> (95.8%), <i>K. pneumonia</i>e (94.3%), and <i>Staphylococcus aureus</i> (100.0%). Only 2.5% of patients reported adverse events. Subgroup analysis showed that pulmonary diseases (<i>P</i> = 0.006), sepsis (<i>P</i> = 0.003), and duration ≤7 days (<i>P</i> < 0.001) of eravacycline 1 mg/kg/12 h were significantly associated with poorer clinical response rate at the end of treatment. Eravacycline demonstrated promising effectiveness and safety in treating infections of patients from the hematology department.