Diarra Ava, Degrendel Maxime, Eberl Isabelle, Ferry Tristan, Jaffal Karim, Escaut Lelia, Khati Antoine Asquier, Taar Nicolas, Courjon Johan, Deconinck Laurène, Lefevre Benjamin, Baldolli Aurélie, Bermejo Messaline, Bleibtreu Alexandre, Dacquet Vincent, de Lastours Victoire, Gazeau Pierre, Larcher Romaric, Patoz Pierre, Robineau Olivier, Rouzic Nicolas, Sayre Naomi, Costescu Strachinaru Diana Isabela, Valentin Benjamin, Wille Heidi, Senneville Eric
Department of Infectious Diseases, Hôpital Gustave Dron, 59200 Tourcoing, France.
Department of Infectious Diseases, Hôpital Avicenne, 75015 Paris, France.
Antibiotics (Basel). 2025 Apr 8;14(4):388. doi: 10.3390/antibiotics14040388.
: Cefiderocol (CFD) is a novel siderophore cephalosporin developed for the treatment of infections involving multidrug-resistant (MDR) Gram-negative bacilli (GNB) infections (1-3). For bone and joint infections (BJIs), the use of CFD is currently neither part of its market authorization nor recommended, and has not yet been assessed by large-scale studies. : To fill the scarcity of data regarding the use of CFD in BJIs, we aimed to describe patients' and infection characteristics along with the outcomes of the infection. : We conducted a retrospective observational multicenter study in 22 French centers from January 2019 to December 2023. : From January 2019 to December 2023, 45 patients were included. Patients were mainly males (73%) with a median age of 62 years (interquartile range [IQR] 29), and a median Charlson comorbidity index of 3. Implant-related infections (20) were the most prominent, accounting for 44% of the cases. Carbapenemase-producing GNB were involved in 74% of the cases ( = 17/23), among which Pseudomonas aeruginosa accounted for 38% of these cases. Most patients received 6 g of CFD per day. CFD was used in combination with an antibiotic in 40 out of 45 cases (89%). The median duration of CFD treatment was 34 days. Seven patients (16%) experienced side effects, mainly gastro-intestinal disorders, including three (7%) who induced treatment cessation. Infection control included surgery in 37 (82%) patients. Failures and deaths occurred, respectively, in 22 (49%) and 10 (22%) cases. : Our results suggest that CFD may be an alternative in MDR-GNB infections with limited therapeutic options.
头孢地尔（CFD）是一种新型的铁载体头孢菌素，用于治疗多重耐药（MDR）革兰氏阴性杆菌（GNB）感染（1 - 3）。对于骨与关节感染（BJI），目前CFD的使用既不在其市场授权范围内，也不被推荐，且尚未经过大规模研究评估。为填补CFD在BJI使用方面的数据空白，我们旨在描述患者及感染特征以及感染的结局。我们在2019年1月至2023年12月期间于法国22个中心进行了一项回顾性观察性多中心研究。2019年1月至2023年12月期间，共纳入45例患者。患者主要为男性（73%），中位年龄62岁（四分位间距[IQR]29），Charlson合并症指数中位数为3。植入物相关感染（20例）最为突出，占病例的44%。产碳青霉烯酶的GNB参与了74%的病例（n = 17/23），其中铜绿假单胞菌占这些病例的38%。大多数患者每天接受6克CFD。45例中有40例（89%）CFD与抗生素联合使用。CFD治疗的中位持续时间为34天。7例患者（16%）出现副作用，主要为胃肠道疾病，其中3例（7%）导致治疗中断。37例（82%）患者的感染控制包括手术。分别有22例（49%）和10例（22%）出现治疗失败和死亡。我们的结果表明，在治疗选择有限的MDR - GNB感染中，CFD可能是一种替代方案。
