Risk factors associated with clinical failure and mortality in Chinese adult patients with community-acquired pneumonia treated with omadacycline: a real-world study
In brief
Omadacycline achieved 86% clinical success in real-world Chinese CAP patients
In a cohort of 150 adults with community-acquired pneumonia, omadacycline led to clinical success in 86% and a 30-day mortality of 6.7%. Respiratory failure and higher Pneumonia Severity Index scores predicted treatment failure, while early failure and elevated SOFA scores forecasted death, underscoring the need to monitor these risk factors.
- Journal
- Journal of global antimicrobial resistance (Q2)
- Published
- 2 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Dan-Li Tian, Gen-Li Han, Yan-Shuang Feng, Hai-Xia Ren, Xiao-Dan Li, Liang Zhang, et al.
- PMID
- 42686024
- DOI
- 10.1016/j.jgar.2026.08.025
Why clinicians should know about it
- Picked for Microbiology (medical) (top studies of the week, 6 September 2026): Real‑world omadacycline effectiveness in CAP
Abstract
OBJECTIVES: While randomized controlled trials demonstrate omadacycline's efficacy and safety in community-acquired pneumonia (CAP), real-world evidence is sparse. This study evaluated clinical effectiveness, safety, and the factors influencing clinical success and 30-day mortality for CAP patients treated with omadacycline in real-world conditions. METHODS: We performed a study of CAP patients treated with omadacycline. The outcomes included clinical efficacy, 30-day mortality, microbial eradication, and adverse events. Multivariate logistic regression identified risk factors for clinical failure, with model performance assessed by Receiver Operating Characteristic (ROC) curves. Kaplan-Meier survival analysis and Cox proportional hazards regression were used to analyze prognostic factors. RESULTS: Among 150 patients, the clinical success rate was 86.0%. Multivariate analysis identified respiratory failure (OR 10.817, 95% CI 1.800-64.990) and higher Pneumonia Severity Index (PSI) score (OR 1.028, 95% CI 1.006-1.051) as independent risk factors for clinical failure. The ROC curve showed the area under the curve (AUC) value of the prediction model was 0.946 (95% CI: 0.904-0.989). The 30-day mortality rate was 6.7%. Kaplan-Meier analysis showed poorer survival for patients with Sequential Organ Failure Assessment (SOFA) score ≥2, PSI >130, age >80 years, ICU admission, or early clinical failure (P < 0.05). Cox regression confirmed early clinical failure (HR 0.031, 95% CI 0.001-0.710) and higher SOFA score (HR 1.500, 95% CI 1.076-2.091) independently predicted 30-day mortality. CONCLUSION: Omadacycline was effective and safe for CAP treatment in real-world practice, including elderly and comorbid patients.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.