%0 Journal Article
%T Compassionate use of cefiderocol in a complex case of extensively drug-resistant Acinetobacter baumannii fracture-related infection: a comprehensive approach and multidisciplinary management.
%A Petrucci F
%A Perciballi B
%A Rivano Capparuccia M
%A Iaiani G
%A Lo Torto F
%A Ribuffo D
%A Gumina S
%A De Meo D
%J Infection
%V 0
%N 0
%D 2024 May 15
%M 38748180
%F 7.455
%R 10.1007/s15010-024-02294-x
%X <B>OBJECTIVE: </B>Fracture-related infections (FRI) pose a difficult management problem, as they require numerous surgical interventions and extended antibiotic treatments, especially when a multidrug-resistant organism is involved, with a paucity of available literature that provides guidance.<BR><B>RESULTS: </B>A 42 year-old male presents an open diaphyseal tibia and fibula fracture, complicated by soft tissue necrosis and infections caused by extensively drug-resistant Acinetobacter baumannii (XDR-Ab). Initially treated with a damage control external fixator, the patient underwent multiple surgical procedures, including radical debridement, negative pressure wound therapy, external fixator revisions and reconstructive surgery using a latissimus dorsi free flap. The emergence of colistin resistance in the Acinetobacter baumannii strain led to the compassionate use of cefiderocol, finally achieving clinical cure.<BR><B>CONCLUSIONS: </B>This case report is one of the firsts that highlights the potential efficacy of cefiderocol in treating challenging bone and joint infections sustained by XDR-Ab. The successful outcome also emphasizes the importance of a comprehensive, multidisciplinary approach in achieving favorable results in complex FRI.