New Perspectives on Antimicrobial Agents: Omadacycline for community-acquired pneumonia, skin and soft tissue infections, and nontuberculous mycobacteria (focus on M. abscessus)

Antimicrob Agents Chemother. 2025 Jan 16:e0108724. doi: 10.1128/aac.01087-24. Online ahead of print.

Abstract

Omadacycline is a novel antimicrobial belonging to the tetracycline class. It has the ability to evade both efflux and ribosomal methylation types of resistance and therefore has an expanded spectrum compared to other tetracycline agents. Omadacycline is active against a number of multidrug-resistant bacteria, including macrolide and doxycycline-resistant Streptococcus pneumoniae, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus, and several enteric gram-negative bacilli. It also has activity against many nontuberculous mycobacterium (NTM) species. It is available both orally and intravenously, which allows for feasible switch therapy. This review will assess the antimicrobial activity, pharmacology, safety, and clinical efficacy of omadacycline and present the opinions of the authors on where to position omadacycline for clinical practice.

Keywords: clinical use; omadacycline; pneumonia; skin infections.