Comment on “Long-term Safety and Tolerability of Omadacycline for the Treatment of <i>Mycobacterium abscessus</i> Infections”

Mycobacterium abscessus (MAB) diseases, especially MAB lung disease (MAB-LD), are extremely difficult to treat, with sustained sputum culture conversion (SSCC) rates of only 34% in macrolide-containing regimens as initial therapy, and in 20% of patients with refractory disease. 1 Omadacycline is a promising drug for MAB diseases with both an oral and intravenous formulation.Recently, two recent case series reported a 75% response rates in patients with M. abscessus infections treated with omadacycline combination regimens. 2,3Omadacycline achieves a 1.5-fold higher 0-24h area under the concentration-time curve (AUC0-24) in the lung than plasma. 4,5Thus far, the 117-patient (95 with MAB-LD) multi-center study by Mingora et al. is the largest to examine the efficacy and tolerability of omadacycline-based multidrug regimens in