Real-life Data on Cefiderocol Efficacy and Safety to Treat Multidrug-Resistant Acinetobacter baumannii Infections.

Autor: Campogiani L; Infectious Diseases Clinic, Policlinico Tor Vergata, Rome, Italy.; Department of Systems Medicine, Tor Vergata University, Rome, Italy., Crea AMA; Infectious Diseases Clinic, Policlinico Tor Vergata, Rome, Italy., Minardi ML; Department of Systems Medicine, Tor Vergata University, Rome, Italy., Ansaldo L; Department of Systems Medicine, Tor Vergata University, Rome, Italy., Coppola L; Infectious Diseases Clinic, Policlinico Tor Vergata, Rome, Italy.; Department of Systems Medicine, Tor Vergata University, Rome, Italy., Compagno M; Infectious Diseases Clinic, Policlinico Tor Vergata, Rome, Italy.; Department of Systems Medicine, Tor Vergata University, Rome, Italy., Vitale P; Infectious Diseases Clinic, Policlinico Tor Vergata, Rome, Italy., Spalliera I; Infectious Diseases Clinic, Policlinico Tor Vergata, Rome, Italy., Malagnino V; Infectious Diseases Clinic, Policlinico Tor Vergata, Rome, Italy.; Department of Systems Medicine, Tor Vergata University, Rome, Italy., Teti E; Infectious Diseases Clinic, Policlinico Tor Vergata, Rome, Italy., D'agostini C; Laboratory of Clinical Microbiology, Policlinico Tor Vergata, Rome, Italy.; Department of Experimental Medicine, Tor Vergata University, Rome, Italy., Pennacchiotti C; Hospital Pharmacy, Policlinico Tor Vergata, Rome, Italy., Abate DN; Hospital Pharmacy, Policlinico Tor Vergata, Rome, Italy., Celeste MG; Hospital Pharmacy, Policlinico Tor Vergata, Rome, Italy., Andreoni M; Infectious Diseases Clinic, Policlinico Tor Vergata, Rome, Italy.; Department of Systems Medicine, Tor Vergata University, Rome, Italy., Iannetta M; Infectious Diseases Clinic, Policlinico Tor Vergata, Rome, Italy.; Department of Systems Medicine, Tor Vergata University, Rome, Italy., Sarmati L; Infectious Diseases Clinic, Policlinico Tor Vergata, Rome, Italy.; Department of Systems Medicine, Tor Vergata University, Rome, Italy.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2023 Dec 21; Vol. 10 (12), pp. ofad627. Date of Electronic Publication: 2023 Dec 21 (Print Publication: 2023).
DOI: 10.1093/ofid/ofad627
Abstrakt: Background: The objective of this study was to expand real-life data on cefiderocol efficacy to treat multidrug-resistant Acinetobacter baumannii infections.
Methods: This was a retrospective monocentric study including patients hospitalized (>24 hours) at Policlinico Tor Vergata, Rome, Italy, between May 1, 2021, and September 1, 2022, treated with cefiderocol (>48 hours). The primary objective was early clinical improvement at 48-72 hours from cefiderocol start; secondary objectives were clinical success (composite outcome of infection resolution and 14-day survival), breakthrough infection, overall 30-day mortality, and cefiderocol-related adverse events.
Results: Eleven patients were enrolled; 91% males (10/11), with a median age (interquartile range [IQR]) of 69 (59-71) years, 91% had ≥1 comorbidity, and 72.7% (8/11) were hospitalized in internal medicine wards. Six patients with bloodstream infection (54.5%; 4 primary, 2 central line-associated), 2 with pneumonia (18.2%), 2 with urinary tract infections (18.2%), and 1 with intra-abdominal infection (9.1%) were treated. Four patients (36.3%) presented with septic shock at cefiderocol start. Cefiderocol was used as monotherapy in 3/11 patients (27.3%), was combined with colistin in all the other 8 cases, and was used in triple combination with tigecycline in 2 patients. The median duration of treatment (IQR) was 12 (10-14) days. Early clinical improvement was documented in 8/11 patients (72.7%), clinical success in 8/11 patients (72.7%). Overall 30-day mortality was 27.3% (3/11), with death occurring a median (IQR) of 19 (17.5-20.5) days after the start of therapy. No cefiderocol-related adverse events were documented.
Conclusions: Cefiderocol seems to be a safe and effective option for multidrug-resistant Acinetobacter baumannii infections.
Competing Interests: Potential conflicts of interest. L.C. received honoraria for lectures from MICOM Srl and research grants from Gilead Italia. E.T. received honoraria for lectures from AbbVie, Gilead, MSD, and Jannsen; participated in advisory boards for Jannsen and Gilead Science; and received a research grant from Gilead Sciences. M.I. received honoraria for lectures from Biogen Italia, AIM Educational, andMICOM srl and research grants from Gilead Italia and Roche; M.I. also participated in an advisory board for BD Biosciences. M.A. received funding for participation in advisory boards, for the preparation of educational materials, for research and educational grants, for participation in speaker panels, and for support for travel to conferences from Gilead Sciences, Janssen-Cilag, Viiv Healthcare, Merck Sharp and Dohme, AbbVie, Angelini, Pfizer, GSK, Menarini, Astra Zeneca, and Moderna. L.S. received a research grant from Gilead and fees for lectures and expertise from Merck, Gilead, and Pfizer. The other authors declare no conflicts of interest.
(© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
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