Omadacycline for the Treatment of Severe Legionella Pneumonia Complicated with Multiple Organ Failure: A Case Report.

Background: Fluoroquinolones and macrolides are the preferred antibiotics for treating Legionnaires' disease. However, the limited utility of these antibiotics in cases of organ dysfunction is a major problem. Omadacycline is a novel tetracycline antibiotic with a good safety profile and in vitro antibacterial activity against Legionella, but it lacks validation by clinical data.

Case description: Here, we report a case of severe pneumonia caused by Legionella infection. The patient was empirically treated with antibiotics, after admission but had a poor clinical outcome with severe hepatic and renal insufficiency. After Legionella infection was confirmed by metagenomic next-generation sequencing, the patient was switched to omadacycline antibiotic therapy and eventually discharged after recovery.

Conclusion: The results of this study suggest that metagenomic next-generation sequencing can facilitate early diagnosis of Legionnaires' disease, and omadacycline can be an alternative antibiotic treatment for severe Legionnaires' disease, especially in patients experiencing multiple organ failure.