Use of Cefiderocol in Adult Patients: Descriptive Analysis from a Prospective, Multicenter, Cohort Study.

Autor: Giacobbe DR; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy. danieleroberto.giacobbe@unige.it.; Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, L.go R. Benzi, 10, 16132, Genoa, Italy. danieleroberto.giacobbe@unige.it., Labate L; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy., Russo Artimagnella C; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.; Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, L.go R. Benzi, 10, 16132, Genoa, Italy., Marelli C; Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, L.go R. Benzi, 10, 16132, Genoa, Italy., Signori A; Section of Biostatistics, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy., Di Pilato V; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy., Aldieri C; Infectious Diseases Unit, S. Croce e Carle Hospital, Cuneo, Italy., Bandera A; Department of Pathophysiology and Transplantation, University of Milano, Milan, Italy.; Infectious Diseases Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico Foundation, Milan, Italy., Briano F; SC Malattie Infettive e Tropicali, Ospedale San Paolo Savona, Savona, Italy., Cacopardo B; Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania, Catania, Italy., Calabresi A; AOU SS Antonio, Biagio e Cesare Arrigo di Alessandria, Alessandria, Italy., Capra Marzani F; SC AR1-Terapia Intensiva Generale, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Carretta A; Department of Medical and Surgical Sciences, Infectious Diseases Unit, University of Foggia, Foggia, Italy., Cattelan A; Infectious and Tropical Diseases Unit, Padua University Hospital, Padua, Italy., Ceccarelli L; Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.; Department of Integrated Management of Infectious Risk, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola, Bologna, Italy., Cenderello G; Department of Infectious Diseases, Sanremo Hospital, Sanremo, Italy., Corcione S; Department of Medical Sciences, Infectious Diseases, University of Turin, Turin, Italy.; Tufts University School of Medicine, Boston, MA, USA., Cortegiani A; Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy.; Department of Anesthesia, Analgesia, Intensive Care and Emergency, University Hospital Policlinico Paolo Giaccone, Palermo, Italy., Cultrera R; Department of Translational Medicine, University of Ferrara, Ferrara, Italy.; Infectious Diseases, Azienda Unità Sanitaria Locale of Ferrara, Ferrara, Italy., De Rosa FG; Department of Medical Sciences, Infectious Diseases, University of Turin, Turin, Italy., Del Bono V; Infectious Diseases Unit, S. Croce e Carle Hospital, Cuneo, Italy., Del Puente F; Department of Infectious Diseases, Galliera Hospital, Genoa, Italy., Fanelli C; Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy., Fava F; Anestesia e Terapia Intensiva Cardiotoracica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Francisci D; Infectious Diseases Clinic, Santa Maria della Misericordia Hospital, Department of Medicine and Surgery, University of Perugia, Perugia, Italy., Geremia N; Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale 'dell'Angelo', Venice, Italy.; Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale Civile 'S.S. Giovanni e Paolo', Venice, Italy., Graziani L; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy., Lombardi A; Department of Pathophysiology and Transplantation, University of Milano, Milan, Italy.; Infectious Diseases Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico Foundation, Milan, Italy., Losito AR; Dipartimento di Scienze Mediche e Chirurgiche, UOC Malattie Infettive, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy., Maida I; Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy., Marino A; Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania, Catania, Italy., Mazzitelli M; Infectious and Tropical Diseases Unit, Padua University Hospital, Padua, Italy., Merli M; ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy., Monardo R; Università Vita-Salute San Raffaele, Milan, Italy.; Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy., Mularoni A; IRCCS-ISMETT, Palermo, Italy., Oltolini C; ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy., Pallotto C; Infectious Diseases Clinic, Santa Maria della Misericordia Hospital, Department of Medicine and Surgery, University of Perugia, Perugia, Italy., Pontali E; Department of Infectious Diseases, Galliera Hospital, Genoa, Italy., Raffaelli F; Dipartimento di Scienze Mediche e Chirurgiche, UOC Malattie Infettive, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy., Rinaldi M; Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.; Department of Integrated Management of Infectious Risk, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola, Bologna, Italy., Ripa M; Università Vita-Salute San Raffaele, Milan, Italy.; Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy., Santantonio TA; Department of Medical and Surgical Sciences, Infectious Diseases Unit, University of Foggia, Foggia, Italy., Serino FS; Azienda ULSS4 Veneto Orientale, UOS Malattie Infettive, UOC Medicina Generale Portogruaro, Portogruaro, Italy., Spinicci M; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.; Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy., Torti C; Dipartimento di Scienze Mediche e Chirurgiche, UOC Malattie Infettive, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.; Dipartimento di Sicurezza e Bioetica, Università Cattolica del Sacro Cuore, Sez. Malattie Infettive, Rome, Italy., Trecarichi EM; Department of Medical and Surgical Sciences, University 'Magna Graecia', Catanzaro, Italy.; 'R. Dulbecco' Teaching Hospital, Catanzaro, Italy., Tumbarello M; Department of Medical Biotechnologies, University of Siena, Siena, Italy.; Infectious and Tropical Diseases Unit, Azienda Ospedaliero Universitaria Senese, Siena, Italy., Mikulska M; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.; Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, L.go R. Benzi, 10, 16132, Genoa, Italy., Giacomini M; Department of Informatics, Bioengineering, Robotics and System Engineering (DIBRIS), University of Genoa, Genoa, Italy., Marchese A; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.; UO Microbiologia, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Vena A; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.; Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, L.go R. Benzi, 10, 16132, Genoa, Italy., Bassetti M; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.; Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino, L.go R. Benzi, 10, 16132, Genoa, Italy.
Jazyk: angličtina
Zdroj: Infectious diseases and therapy [Infect Dis Ther] 2024 Sep; Vol. 13 (9), pp. 1929-1948. Date of Electronic Publication: 2024 Jul 12.
DOI: 10.1007/s40121-024-01016-y
Abstrakt: Introduction: Cefiderocol is a siderophore cephalosporin showing activity against various carbapenem-resistant Gram-negative bacteria (CR-GNB). No data currently exist about real-world use of cefiderocol in terms of types of therapy (e.g., empirical or targeted, monotherapy or combined regimens), indications, and patient characteristics.
Methods: In this multicenter, prospective study, we aimed at describing the use of cefiderocol in terms of types of therapy, indications, and patient characteristics.
Results: Cefiderocol was administered as empirical and targeted therapy in 27.5% (55/200) and 72.5% (145/200) of cases, respectively. Overall, it was administered as monotherapy in 101/200 cases (50.5%) and as part of a combined regimen for CR-GNB infections in the remaining 99/200 cases (49.5%). In multivariable analysis, previous isolation of carbapenem-resistant Acinetobacter baumannii odds ratio (OR) 2.56, with 95% confidence interval (95% CI) 1.01-6.46, p = 0.047] and previous hematopoietic stem cell transplantation (OR 8.73, 95% CI 1.05-72.54, p = 0.045) were associated with administration of cefiderocol as part of a combined regimen, whereas chronic kidney disease was associated with cefiderocol monotherapy (OR 0.38 for combined regimen, 95% CI 0.16-0.91, p = 0.029). Cumulative 30-day mortality was 19.8%, 45.0%, 20.7%, and 22.7% in patients receiving targeted cefiderocol for infections by Enterobacterales, A. baumannii, Pseudomonas aeruginosa, and any metallo-β-lactamase producers, respectively.
Conclusions: Cefiderocol is mainly used for targeted treatment, although empirical therapies account for more than 25% of prescriptions, thus requiring dedicated standardization and guidance. The almost equal distribution of cefiderocol monotherapy and cefiderocol-based combination therapies underlines the need for further study to ascertain possible differences in efficacy between the two approaches.
(© 2024. The Author(s).)
Databáze: MEDLINE
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