Giacobbe Daniele Roberto, Ciacco Eugenio, Girmenia Corrado, Pea Federico, Rossolini Gian Maria, Sotgiu Giovanni, Tascini Carlo, Tumbarello Mario, Viale Pierluigi, Bassetti Matteo
Clinica Malattie Infettive, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy.
Department of Health Sciences, University of Genoa, Genoa, Italy.
Infect Drug Resist. 2020 Dec 29;13:4697-4711. doi: 10.2147/IDR.S205309. eCollection 2020.
Infections due to multidrug-resistant Gram-negative bacteria (MDR-GNB), especially when carbapenem resistant, have been very difficult to manage in the last fifteen years, owing to the paucity of dependable therapeutic options. Cefiderocol is a siderophore cephalosporin recently approved by the Food and Drug Administration (FDA) and European Medicines Agency (EMA) that may have the potential to fill some of the remaining gaps in the treatment of MDR-GNB infections. Among others, cefiderocol demonstrated in vitro activity against carbapenem-resistant and metallo-β-lactamases producers. Clinical data from both registrative studies and post-marketing experiences are essential to confirm whether these promises from in vitro studies could readily translate into clinical practice, as well as to delineate the precise place in therapy for cefiderocol for the treatment of MDR-GNB in the near future. Because of its unique potential, it is essential to provide both randomized controlled trials (RCT) and real-life data to improve the ability of clinicians to exploit its benefit in both empirical and targeted treatment of MDR-GNB infections. In this narrative review, we discuss the emerging data from pivotal RCT and initial real-life experiences on the use of cefiderocol for the treatment of MDR-GNB infections.
在过去十五年中，耐多药革兰氏阴性菌（MDR-GNB）引起的感染，尤其是对碳青霉烯类耐药的感染，由于可靠治疗选择匮乏，一直很难处理。头孢地尔是一种铁载体头孢菌素，最近获得了美国食品药品监督管理局（FDA）和欧洲药品管理局（EMA）的批准，可能有潜力填补耐多药革兰氏阴性菌感染治疗中一些尚存的空白。其中，头孢地尔对耐碳青霉烯类和产金属β-内酰胺酶的菌株表现出体外活性。注册研究和上市后经验的临床数据对于确认体外研究的这些前景能否顺利转化为临床实践，以及在不久的将来明确头孢地尔在耐多药革兰氏阴性菌感染治疗中的精确治疗地位至关重要。由于其独特的潜力，提供随机对照试验（RCT）和真实世界数据以提高临床医生在耐多药革兰氏阴性菌感染的经验性和靶向治疗中利用其益处的能力至关重要。在这篇叙述性综述中，我们讨论了关于使用头孢地尔治疗耐多药革兰氏阴性菌感染的关键随机对照试验和初步真实世界经验的新数据
