Cefiderocol for Severe Carbapenem-Resistant A. baumannii Pneumonia: Towards the Comprehension of Its Place in Therapy

Rando, Emanuele; Segala, Francesco Vladimiro; Vargas, Joel; Seguiti, Cristina; Pascale, Gennaro De; Murri, Rita; Fantoni, Massimo

doi:10.3390/antibiotics11010003

Cited by 28 publications

(20 citation statements)

References 27 publications

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“…Despite our moderate results in patients with VAP, sufficient lung penetration of cefiderocol has previously been demonstrated in mechanically ventilated critically ill patients with pneumonia, by measuring its concentration in the epithelial lining fluid [ 10 , 26 ]. Overall, our results for clinical cure (90%) and microbiological cure (80%) are in concordance with previous case series in which clinical cure was achieved in 54 to 100% of the patients [ 14 , 15 , 18 – 20 , 23 , 27 ] and microbiological cure in 60 to 100% [ 14 , 17 , 18 , 20 , 23 ].…”

Section: Discussionsupporting

confidence: 92%

“…This study is among the few case series describing the real-life use of cefiderocol and is the largest conducted in Spain. We included infections caused by different microorganisms (CRE, DTR-PA, CRAB, and A. xylosoxidans ), in contrast with some previously described series where the main pathogen isolated was either A. baumannii [ 15 , 16 , 18 , 19 , 21 ], P. aeruginosa [ 14 ], or A. xylosoxidans [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

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Real-Life Data on the Effectiveness and Safety of Cefiderocol in Severely Infected Patients: A Case Series

et al. 2023

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Introduction Real-life data about cefiderocol use to treat extensively drug-resistant bacteria are scarce. We aim to report our early experience in patients with difficult-to-treat infections and limited therapeutic options. Methods Patients treated with cefiderocol from March 2018 to April 2022 in a tertiary-care hospital in Spain were included. Demographic, clinical, and microbiological data were collected up to 90 days after the end of treatment or until death. Survival status was recorded at 30 and 90 days. Results Ten patients were included, seven of them critically ill. Ventilator-associated pneumonia (40%) and bacteremia (40%) were the main infections. Multidrug-resistant or extensively drug-resistant P. aeruginosa was the most frequently isolated pathogen (70%, of which six patients were infected with bacteria with difficult-to-treat resistance), followed by A. baumannii , E. coli , and A. xylosoxidans (10% each). Seven patients received combination therapy. Clinical and microbiological cures were achieved in 90% and 80% of patients, respectively. Two previously susceptible strains (20%) developed resistance to cefiderocol. Overall, 30-day and 90-day mortality rates were 10% and 50%, respectively, although two out of five patients died due to the infection. No serious adverse events were reported, except for one patient who developed thrombocytopenia. Conclusion Cefiderocol seems to be an effective and safe rescue therapy for patients infected with difficult-to-treat pathogens, although there is a definite risk of the emergence of resistance.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Real-Life Data on the Effectiveness and Safety of Cefiderocol in Severely Infected Patients: A Case Series

et al. 2023

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“…Primary infections were contracted in 12 different countries, including Afghanistan ( n = 1, [ 32 ]), Australia ( n = 1, [ 25 ]), Belgium ( n = 1, [ 36 ]), Columbia ( n = 1, [ 39 ]), France ( n = 2, [ 28 , 31 ]), Italy ( n = 5, [ 23 , 26 , 28 , 29 , 35 , 37 ]), Kuwait ( n = 1, [ 34 ]), Nigeria ( n = 1, [ 21 ]), Serbia ( n = 1, [ 39 ]), Spain ( n = 1, [ 24 ]), Thailand ( n = 1, [ 39 ]), and US ( n = 4, [ 27 , 33 , 38 ]). In Bassetti et al, patients came from 16 different countries in North America ( n = 6), South America ( n = 9), Europe ( n = 57) and Asia ( n = 29).…”

Section: Resultsmentioning

confidence: 99%

“…Therapeutic regimen . A regimen of 2 g every 8 h was used for 40 patients [ 25 , 27 , 28 , 29 , 31 , 32 , 36 , 38 , 39 , 40 ]. Basetti et al used a regimen of 2 g every 8 h, with dosage adjustments for altered renal function.…”

Section: Resultsmentioning

confidence: 99%

Cefiderocol for Carbapenem-Resistant Bacteria: Handle with Care! A Review of the Real-World Evidence

et al. 2022

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(1) Background: healthcare-associated infections are one of the most frequent adverse events in healthcare delivery worldwide. Several antibiotic resistance mechanisms have been developed, including those to carbapenemase. Cefiderocol (CFD) is a novel siderophore cephalosporin designed to treat carbapenem-resistant bacteria. (2) Methods: we performed a systematic review of all cases reported in the literature to outline the existing evidence. We evaluated real-world evidence studies of CFD in the treatment of carbapenem-resistant (CR) bacteria. (3) Results: a total of 19 publications treating cases of infection by CR bacteria were included. The three most frequent CR pathogens were Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae. A regimen of 2 g every 8 h was most frequently adopted for CFD with a mean treatment duration of 25.6 days. CFD was generally well tolerated, with fewer side effects. The success rate of CFD therapy was satisfactory and almost 70% of patients showed clinical recovery; of these, nearly half showed negative blood cultures and infection-free status. (4) Conclusions: This review indicates that CFD is active against important GN organisms including Enterobacteriaceae, P. aeruginosa, and A. baumannii. CFD seems to have a safe profile.

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“…Meanwhile, Rando and colleagues describe a case series on Acinetobacter MDR infections and the use and efficacy of cefiderocol [ 9 ]. Their work is highly relevant and may contribute to redefining cefiderocol’s role in treating severe carbapenem-resistant A. baumannii pneumonia, adding new information from clinical experience with this drug to the current body of knowledge.…”

mentioning

confidence: 99%

Antibiotics and Infectious Respiratory Diseases

2022

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Cefiderocol for Severe Carbapenem-Resistant A. baumannii Pneumonia: Towards the Comprehension of Its Place in Therapy

Cited by 28 publications

References 27 publications

Real-Life Data on the Effectiveness and Safety of Cefiderocol in Severely Infected Patients: A Case Series

Real-Life Data on the Effectiveness and Safety of Cefiderocol in Severely Infected Patients: A Case Series

Cefiderocol for Carbapenem-Resistant Bacteria: Handle with Care! A Review of the Real-World Evidence

Antibiotics and Infectious Respiratory Diseases

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