Omadacycline in pediatric patients with predominantly pulmonary infections: a retrospective, real-world study

Omadacycline is the latest generation of tetracycline with broad-spectrum antibacterial activity. However, its application in pediatric patients with bacterial infection has not yet been reported. This study aimed to evaluate the efficacy and safety of omadacycline in the pediatric population. Patients aged 8–17 years who received omadacycline for infectious diseases were retrospectively included. Clinical effectiveness and failure were assessed on the day before discharge. Effective was defined as complete resolution or significant improvement of infection-related symptoms and signs without the need for additional antimicrobial therapy. Among the 267 patients included, 20 (7.5%) were cured, 109 (40.8%) were markedly effective, and 115 (43.1%) were improved, yielding a clinical effective rate of 91.4%. The clinical ineffective rate was 8.6%. Pulmonary infection (versus others, P = 0.012) and a longer duration of combination therapy ( P = 0.030) were associated with a greater probability of achieving effective efficacy. Patients’ body temperature decreased continuously after medication ( P < 0.001). Compared with the ineffective group, the effective group had a lower body temperature at days 3 ( P = 0.035) and 4 ( P = 0.002) after medication. Only 5 patients had mild liver injury after medication, while no moderate or severe liver injury was noted. The indices of routine blood examination, liver function, and renal function before and after medication were all within the normal range, and the changes lacked clinical significance. Omadacycline was associated with favorable clinical outcomes and an acceptable short-term safety profile in this retrospective cohort; however, prospective controlled studies are needed to confirm these findings.