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Real-life Data on Cefiderocol Efficacy and Safety to Treat Multidrug-Resistant Acinetobacter baumannii Infections
Laura Campogiani1,2, Angela Maria Antonia Crea1, Maria Letizia Minardi2
1Infectious Diseases Clinic, Policlinico Tor Vergata, Rome, Italy.
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.
Insights
Cefiderocol shows promise for treating difficult multidrug-resistant Acinetobacter baumannii infections, demonstrating good clinical improvement and success rates with no reported adverse events in real-world data.
Area of Science:
- Infectious Diseases
- Pharmacology
- Critical Care Medicine
Background:
- Multidrug-resistant Acinetobacter baumannii (MDR-AB) poses a significant clinical challenge.
- Real-world data on cefiderocol efficacy for MDR-AB infections are limited.
Purpose of the Study:
- To evaluate the real-world effectiveness and safety of cefiderocol in patients with MDR-AB infections.
- To assess early clinical improvement, clinical success, and mortality rates.
Main Methods:
- Retrospective monocentric study of 11 hospitalized patients treated with cefiderocol.
- Data collected on clinical improvement, success, mortality, and adverse events.
- Cefiderocol use in monotherapy or combination with colistin and/or tigecycline.
Main Results:
- 72.7% of patients showed early clinical improvement and clinical success.
- 30-day mortality was 27.3%.
- No cefiderocol-related adverse events were observed.
Conclusions:
- Cefiderocol appears to be a safe and effective treatment option for MDR-AB infections.
- Real-world data support cefiderocol's utility in challenging infections.
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