Work

Physical compatibility of omadacycline with intravenous agents used in the treatment of Mycobacteroides abscessus pulmonary disease

Year: 2025

Type: article

Abstract: PURPOSE: Omadacycline is a tetracycline antibiotic approved for the treatment of community-acquired bacterial pneumonia and possesses activity against pulmonary infections caused by Mycobacteroides abscessus (formerly Mycobacterium abscessus). Initial therapy for pulmonary M. abscessus disease often consists of a combination of intravenous agents, which may include intravenous omadacycline. The physical compatibility of omadacycline with other intravenous agents used in the treatment of pulmonary M. abscessus disease is unknown. METHODS: Physical compatibility of omadacycline 1 mg/mL was assessed via actual Y-site infusion with amikacin, azithromycin, cefoxitin, imipenem/cilastatin, and linezolid. Assessments of the triple-agent combinations of omadacycline with linezolid plus amikacin and imipenem/cilastatin plus amikacin were also performed. As needed, agents were reconstituted with sterile water for injection and diluted in 0.9% sodium chloride injection to typical clinical concentrations. Each combination was tested for compatibility using visual, laser light scattering, microscopy, pH, and turbidity assessments. Samples were taken from the start and end of a typical 30-minute omadacycline infusion and assessed immediately and again 2 hours after mixing. All experiments were performed in triplicate. RESULTS: No physical incompatibility was demonstrated with any tested combination of agents with any method at any time point. Results were consistent across experiments. CONCLUSION: At clinical concentrations of agents used in the treatment of pulmonary M. abscessus disease, omadacycline appears to be physically compatible in dual-agent combinations in Y-site infusion with amikacin, azithromycin, cefoxitin, imipenem/cilastatin, and linezolid, as well as in triple combinations of omadacycline plus imipenem/cilastatin and amikacin and omadacycline plus linezolid and amikacin.

Source: American Journal of Health-System Pharmacy

DOI: 10.1093/ajhp/zxaf299

Authors: David A Butler, Kelly Moolick

Institutions: Notre Dame of Maryland University, Albany College of Pharmacy and Health Sciences

Language: English

Topic: Mycobacterium research and diagnosis

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,448