%0 Journal Article
%T Use of Cefiderocol in Adult Patients: Descriptive Analysis from a Prospective, Multicenter, Cohort Study.
%A Giacobbe DR
%A Labate L
%A Russo Artimagnella C
%A Marelli C
%A Signori A
%A Di Pilato V
%A Aldieri C
%A Bandera A
%A Briano F
%A Cacopardo B
%A Calabresi A
%A Capra Marzani F
%A Carretta A
%A Cattelan A
%A Ceccarelli L
%A Cenderello G
%A Corcione S
%A Cortegiani A
%A Cultrera R
%A De Rosa FG
%A Del Bono V
%A Del Puente F
%A Fanelli C
%A Fava F
%A Francisci D
%A Geremia N
%A Graziani L
%A Lombardi A
%A Losito AR
%A Maida I
%A Marino A
%A Mazzitelli M
%A Merli M
%A Monardo R
%A Mularoni A
%A Oltolini C
%A Pallotto C
%A Pontali E
%A Raffaelli F
%A Rinaldi M
%A Ripa M
%A Santantonio TA
%A Serino FS
%A Spinicci M
%A Torti C
%A Trecarichi EM
%A Tumbarello M
%A Mikulska M
%A Giacomini M
%A Marchese A
%A Vena A
%A Bassetti M
%A  
%J Infect Dis Ther
%V 0
%N 0
%D 2024 Jul 12
%M 38995601
%F 6.119
%R 10.1007/s40121-024-01016-y
%X <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>In this multicenter, prospective study, we aimed at describing the use of cefiderocol in terms of types of therapy, indications, and patient characteristics.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.