Long-Term Compassionate Use of Cefiderocol To Treat Chronic Osteomyelitis Caused by Extensively Drug-Resistant Pseudomonas aeruginosa and Extended-Spectrum-β-Lactamase-Producing Klebsiella pneumoniae in a Pediatric Patient

Alamarat, Zain; Babic, Jessica T.; Tran, Truc T.; Wootton, Susan H.; Dinh, An Q; Miller, William R.; Hanson, Blake; Wanger, Audrey; Gary, Joshua L.; Arias, César A.; Pérez, Norma

doi:10.1128/aac.01872-19

Cited by 50 publications

(53 citation statements)

References 14 publications

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“…To our knowledge, this is the first case of PJI due to XDR Enterobacterales successfully treated with cefiderocol monotherapy. Alamarat et al reported a compassionate use of cefiderocol to treat chronic osteomyelitis caused by metallo-β-lactamase (MBL)-producing Pseudomonas aeruginosa and an ESBL-producing Klebsiella pneumoniae in a 15-year-old patient [2]. The patient had a successful clinical outcome, with only self-resolved possible hematological toxicity.…”

Section: Discussionmentioning

confidence: 99%

Compassionate Use of Cefiderocol to Treat a Case of Prosthetic Joint Infection Due to Extensively Drug-Resistant Enterobacter hormaechei

et al. 2020

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We report the case of a 67-year old man with a right knee prosthetic joint infection due to extensively drug-resistant Enterobacter hormaechei. The resistance phenotype was due to the overproduction of the intrinsic cephalosporinase (ACT-5) associated with the production of three acquired β-lactamases (CTX-M-15, TEM-1B and OXA-1), and a putative membrane decreased permeability. He was first treated with colistin-tigecyclin due to adverse drug reactions; treatment was switched to cefiderocol for a 12-week antibiotic duration, with a favorable outcome.

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Section: Discussionmentioning

confidence: 99%

Compassionate Use of Cefiderocol to Treat a Case of Prosthetic Joint Infection Due to Extensively Drug-Resistant Enterobacter hormaechei

et al. 2020

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“…Ce derocol has been used for a longer period in some compassionate treatments like osteomyelitis (14 weeks), intra-abdominal (28 days) and endovascular infections (30 days) due to XDR germs. All three patients recovered and no emergence of resistance to ce derocol was reported (10,11,12).…”

Section: Introductionmentioning

confidence: 85%

In vivo emergence of resistance to cefiderocol in an XDR Pseudomonas aeruginosa and an MDR Citrobacter koseri after prolonged therapy: a case report.

Perez¹,

Maillart²,

Deyi³

et al. 2020

Preprint

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The non-fermenters, e.g. Pseudomonas aeruginosa, and the extended spectrum β-lactamases or carbapenemases producing enterobacteriaceae represent a serious threat for patients admitted in Intensive Care Units (ICUs). News antibiotics have been developed to treat multidrug resistant bacteria. However, treatment emerging resistance has been shown for many of these newest antibiotics. Cefiderocol, a siderophore-antibiotic, has been developed to overcome most of the resistance mechanisms and shows great efficacy against most multi-drug resistant and extensively drug resistant Gram-negative bacteria, including the non-fermenters. We report the case of a patient abundantly treated with antibiotics. He received 158 days of antibiotherapy on 230 hospitalization days, including a six-week course of cefiderocol, in 14 different treatment lines. The patient developed a Pseudomonas aeruginosa (MIC: 8 µg/ml, GES type ESBL) and a Citrobacter koseri (MIC: 16 µg/ml, CTX-M group 9 type class A β-lactamase and a class D OXA-1 oxacillinase) resistant to cefiderocol. This antibiotic should be used with caution to preserve its efficacy, within a strict antimicrobial stewardship program.

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“…Combination therapy with aztreonam and cefiderocol was originally used, but aztreonam was discontinued after 2 weeks due to increasing liver function markers. Intermittent episodes of decreased white cell count with nadir at 1200/mm 3 was noted on cefiderocol therapy and resolved spontaneously without any adjustments [45].…”

Section: Clinical Efficacymentioning

confidence: 99%

Cefiderocol: A Novel Agent for the Management of Multidrug-Resistant Gram-Negative Organisms

2020

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Cefiderocol, formerly S-649266, is a first in its class, an injectable siderophore cephalosporin that combines a catechol-type siderophore and cephalosporin core with side chains similar to cefepime and ceftazidime. This structure and its unique mechanism of action confer enhanced stability against hydrolysis by many b-lactamases, including extended spectrum b-lactamases such as CTX-M, and carbapenemases such as KPC, NDM, VIM, IMP, OXA-23, OXA-48-like, OXA-51-like and OXA-58. Cefiderocol's spectrum of activity encompasses both lactosefermenting and non-fermenting Gram-negative pathogens, including carbapenem-resistant Enterobacterales. Cefiderocol recently received US Food and Drug Administration approval for the treatment of complicated urinary tract infections, including pyelonephritis, and is currently being evaluated in phase III trials for nosocomial pneumonia and infections caused by carbapenem-resistant Gram-negative pathogens. The purpose of this article is to review existing data on the mechanism of action, microbiology, pharmacokinetics, pharmacodynamics, efficacy, and safety of cefiderocol to assist clinicians in determining its place in therapy.

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Long-Term Compassionate Use of Cefiderocol To Treat Chronic Osteomyelitis Caused by Extensively Drug-Resistant Pseudomonas aeruginosa and Extended-Spectrum-β-Lactamase-Producing Klebsiella pneumoniae in a Pediatric Patient

Cited by 50 publications

References 14 publications

Compassionate Use of Cefiderocol to Treat a Case of Prosthetic Joint Infection Due to Extensively Drug-Resistant Enterobacter hormaechei

Compassionate Use of Cefiderocol to Treat a Case of Prosthetic Joint Infection Due to Extensively Drug-Resistant Enterobacter hormaechei

In vivo emergence of resistance to cefiderocol in an XDR Pseudomonas aeruginosa and an MDR Citrobacter koseri after prolonged therapy: a case report.

Cefiderocol: A Novel Agent for the Management of Multidrug-Resistant Gram-Negative Organisms

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