INTRODUCTION: This study aimed to reevaluate the clinical efficacy and safety of omadacycline in treating acute bacterial infections. METHODS: We searched PubMed, Embase, Cochrane Library, Web of Science, and Clinical Trials up to 1 January 2024, including only randomized controlled trials comparing OMC with other antibiotics in adults. Primary outcomes were clinical and microbiological responses
secondary outcomes included adverse events. RESULTS: Seven RCTs with 2957 patients met the inclusion criteria. OMC showed a slightly better clinical response at the post-therapy evaluation phase in the clinically evaluable population (RR = 1.03, 95% CI = 1.01-1.05, I CONCLUSIONS: OMC is a safe and effective treatment for acute bacterial infections, comparable to other antibiotics. REGISTRATION: This study has been registered in the online systematic review database (Prospective Register of Systematic Reviews [PROSPERO]), and the registration number is CRD42024575416.