SynthesisEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2026
Resistance of gram-negative and gram-positive pathogens to omadacycline: a systematic review.
Synthesis in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionOmadacycline is a semisynthetic aminomethylcycline, tetracycline-type antibiotic, approved by the Food and Drug Administration (FDA) for treating patients with acute bacterial skin and skin structure infections (ABSSSI) and community-acquired bacterial pneumonia (CABP). This study aimed to assess the in vitro activity of omadacycline against Gram-positive and Gram-negative bacteria.
methodsThis systematic review was done according to the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) guidelines. A search was conducted across five databases (Google Scholar, Web of Science, Embase, Scopus, and PubMed) to identify relevant articles from their inception to October 2025. The data were interpreted in accordance with the FDA omadacycline resistance breakpoints for ABSSSI and CABP.
resultsIn total, 31 relevant studies were included. The resistance of methicillin-resistant (MRSA) and methicillin-susceptible (MSSA) Staphylococcus aureus isolates to omadacycline was 0-13% and 0.3-0.7%, respectively. The resistance of Enterococcus faecalis, Streptococcus pneumoniae, and Streptococcus pyogenes isolates was 0%-2.2%, 0%-0.8%, and 0%-0.2%, respectively. Regarding Gram-negative bacteria, the resistance of Hemophilus influenzae isolates to omadacycline was 0%-0.2%, of Enterobacter cloacae 0.3%-25.8%, and of Klebsiella pneumoniae 0%-100%.
conclusionOmadacycline demonstrated good in vitro activity against S. pneumoniae, H. influenzae, S. aureus (both MSSA and MRSA), and E. faecalis. The activity against E. cloacae was also considerable. However, the drug demonstrated limited activity against K. pneumoniae.
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