Compassionate use of cefiderocol for carbapenem-resistant Acinetobacter baumannii prosthetic joint infection
| Autor: | David W. Wareham, Mei Gie Meiqi Tan, Benny P. Cherian, Caoimhe NicFhogartaigh, Diana Ayoola Mabayoje |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty biology business.industry medicine.drug_class 030106 microbiology Antibiotics Surgical wound Tigecycline biology.organism_classification Antimicrobial Acinetobacter baumannii 03 medical and health sciences AcademicSubjects/MED00290 030104 developmental biology Antibiotic resistance Supplement Papers Internal medicine Tobramycin Colistin AcademicSubjects/MED00740 Medicine AcademicSubjects/MED00230 business medicine.drug |
| Zdroj: | JAC-Antimicrobial Resistance |
| ISSN: | 2632-1823 |
| Popis: | Background Cefiderocol is a recently licensed novel siderophore-conjugated cephalosporin stable to hydrolysis by serine and MBLs. It has been successfully used to treat Enterobacterales infections and is approved for the treatment of infections due to aerobic Gram-negative organisms in adults with limited treatment options. Objectives To describe the compassionate use of cefiderocol and clinical outcome in a case of prosthetic joint infection due to MDR Acinetobacter baumannii. Patients and methods This case study follows a 66-year-old woman who sustained an open fracture of the left distal humerus in Pakistan. She underwent open reduction and internal fixation and on return to the UK presented to hospital with a discharging surgical wound. Results Debridement of her wound cultured NDM carbapenemase-producing A. baumannii susceptible to colistin, tobramycin and tigecycline only. She developed vomiting with acute kidney injury with colistin and tigecycline. Antimicrobial efficacy of cefiderocol was predicted from in vitro and in vivo susceptibility tests. A successful request was made to Shionogi for compassionate use of cefiderocol, which was added to tigecycline. Cefiderocol was well tolerated with no toxicity and improved renal function. In total she received 25 days of cefiderocol and continued on tigecycline for a further 6 weeks in the community. She has well-healed wounds and good range of elbow movement. Conclusions Cefiderocol’s novel mode of cell entry is effective against MDR Gram-negative bacteria with reduced toxicity compared with other last line antibiotics. Our case demonstrates that cefiderocol may be useful as therapy for patients with limited treatment options due to antimicrobial resistance. The prescribing information for cefiderocol is available at: https://shionogi-eu-content.com/gb/fetcroja/pi. |
| Databáze: | OpenAIRE |
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