Center of Medicine Clinical Research, Department of Pharmacy, Medical Supplies Center, Chinese PLA General Hospital, Beijing, 100853, People's Republic of China.
Department of Pharmacy, Medical Supplies Center, Chinese PLA General Hospital, Beijing, 100853, People's Republic of China.
BMC Infect Dis. 2024 Feb 19;24(1):219. doi: 10.1186/s12879-024-09097-3.
In the present study, we aimed to compare the clinical efficacy and safety of omadacycline (OMC) with its comparators for the treatment of complicated skin and soft tissue infections (cSSTIs) in adult patients.
Randomized controlled trials (RCTs) evaluating OMC for cSSTIs were searched in databases of PubMed, Embase, Cochrane, Web of Science, and Clinical Trial, up to July 2022. The primary outcomes were clinical efficacy and microbiological response, with secondary outcome was safety.
Four RCTs consisting of 1,757 patients were included, with linezolid (LZD) as a comparator drug. For clinical efficacy, OMC was not inferior to LZD in the modified intent-to-treat (MITT) (OR: 1.24, 95% Cl: [0.93, 1.66], P = 0.15) and clinically evaluable (CE) populations (OR: 1.92, 95% Cl: [0.94, 3.92], P = 0.07). For microbiological response, OMC was numerically higher than LZD in the microbiologically evaluable (ME) (OR: 1.74, 95% Cl: [0.81, 3.74], P = 0.16) and microbiological MITT (micro-MITT) populations (OR: 1.27, 95% Cl: [0.92, 1.76], P = 0.14). No significant difference was found in subpopulations of monomicrobial or polymicrobial mixed infection populations. The mortality and adverse event rates were similar between OMC and LZD.
OMC was as good as LZD in terms of clinical efficacy and microbiological response, and has similar safety issues in treating cSSTIs. OMC might be a promising option for treating cSSTIs in adult patients.
本研究旨在比较 omadacycline(OMC)与对照药物治疗成人复杂性皮肤和软组织感染(cSSTIs)的临床疗效和安全性。
检索了 PubMed、Embase、Cochrane、Web of Science 和 ClinicalTrials.gov 数据库中评估 OMC 治疗 cSSTIs 的随机对照试验(RCT),检索时间截至 2022 年 7 月。主要结局为临床疗效和微生物学应答,次要结局为安全性。
纳入了 4 项 RCT,共 1757 例患者,以利奈唑胺(LZD)作为对照药物。对于临床疗效,在改良意向治疗(MITT)(OR:1.24,95% Cl:[0.93,1.66],P=0.15)和临床可评估(CE)人群中,OMC 与 LZD 无差异。对于微生物学应答,在可评估微生物学(ME)(OR:1.74,95% Cl:[0.81,3.74],P=0.16)和微生物学 MITT(micro-MITT)人群中,OMC 略高于 LZD(OR:1.27,95% Cl:[0.92,1.76],P=0.14)。在单微生物或多微生物混合感染人群的亚组中未发现差异。OMC 与 LZD 的死亡率和不良事件发生率相似。
在临床疗效和微生物学应答方面,OMC 与 LZD 相当,且在治疗 cSSTIs 方面具有相似的安全性问题。OMC 可能是治疗成人 cSSTIs 的一种有前途的选择。