Department of Pharmacy, Advocate Lutheran General Hospital, 1775 Dempster Street, Park Ridge, IL, 60068, USA.
Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA.
Infection. 2023 Apr;51(2):475-482. doi: 10.1007/s15010-022-01933-5. Epub 2022 Oct 6.
This case series describes real-world utilization of cefiderocol and associated clinical outcomes in the setting of carbapenem-resistant Gram-negative bacterial infections.
Adult hospitalized patients administered at least 5 days of cefiderocol as definitive treatment from October 1, 2020 to September 16, 2021 were included in this retrospective cohort analysis. The primary outcome was clinical success defined as a composite of 30 day survival, resolution of infection, and absence of 30 day recurrence of the same organism.
Among 24 patients, pneumonia (19, 79%) was the most common source of infection with Acinetobacter baumannii (14, 58%) and P. aeruginosa (10, 42%) as the predominant organisms isolated. Cefiderocol monotherapy was used as definitive treatment in 16 (67%) patients. Eleven patients (46%) met clinical success. Thirty-day mortality occurred in ten (42%) patients while seven (29%) patients had recurrence of infection. Thirteen out of 21 total isolates (62%) tested for susceptibility were deemed susceptible. Of the 16 patients with available susceptibility, 9 (56%) had an infection where all isolated organisms were susceptible to cefiderocol.
Our results provide additional insight into the in vivo activity of cefiderocol. Cefiderocol remains a salvage option for carbapenem-resistant Gram-negative organisms.
本病例系列描述了碳青霉烯类耐药革兰氏阴性菌感染患者使用头孢他啶的真实世界应用和相关临床结局。
本回顾性队列分析纳入了 2020 年 10 月 1 日至 2021 年 9 月 16 日期间至少接受 5 天头孢他啶作为明确治疗的住院成年患者。主要结局为 30 天生存率、感染缓解和相同病原体 30 天复发均为阴性的复合临床成功率。
在 24 名患者中，肺炎（19 例，79%）是最常见的感染源，主要分离菌为鲍曼不动杆菌（14 例，58%）和铜绿假单胞菌（10 例，42%）。16 名（67%）患者使用头孢他啶单药治疗作为明确治疗。11 名（46%）患者符合临床成功标准。30 天死亡率为 10 例（42%），7 例（29%）患者发生感染复发。21 株总分离株中，有 13 株（62%）进行了药敏试验，被认为是敏感的。在有药敏数据的 16 名患者中，9 名（56%）的感染中所有分离菌均对头孢他啶敏感。
我们的结果为头孢他啶的体内活性提供了更多的见解。头孢他啶仍然是治疗碳青霉烯类耐药革兰氏阴性菌的一种挽救选择。
