{Reference Type}: Journal Article
{Title}: Use of Cefiderocol in Adult Patients: Descriptive Analysis from a Prospective, Multicenter, Cohort Study.
{Author}: Giacobbe DR;Labate L;Russo Artimagnella C;Marelli C;Signori A;Di Pilato V;Aldieri C;Bandera A;Briano F;Cacopardo B;Calabresi A;Capra Marzani F;Carretta A;Cattelan A;Ceccarelli L;Cenderello G;Corcione S;Cortegiani A;Cultrera R;De Rosa FG;Del Bono V;Del Puente F;Fanelli C;Fava F;Francisci D;Geremia N;Graziani L;Lombardi A;Losito AR;Maida I;Marino A;Mazzitelli M;Merli M;Monardo R;Mularoni A;Oltolini C;Pallotto C;Pontali E;Raffaelli F;Rinaldi M;Ripa M;Santantonio TA;Serino FS;Spinicci M;Torti C;Trecarichi EM;Tumbarello M;Mikulska M;Giacomini M;Marchese A;Vena A;Bassetti M; ;
{Journal}: Infect Dis Ther
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jul 12
{Factor}: 6.119
{DOI}: 10.1007/s40121-024-01016-y
{Abstract}: <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.