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Cefiderocol Treatment for Severe Infections due to Difficult-to-Treat-Resistant Non-Fermentative Gram-Negative Bacilli in ICU Patients: A Case Series and Narrative Literature Review

by Lê, Minh , Kramer, Laura , Wicky, Paul-Henri , Armand-Lefèvre, Laurence , Timsit, Jean-François , de Montmollin, Étienne , Patrier, Juliette , d’Humières, Camille , Alves, Manuel , Poiraud, Joséphine , Massias, Laurent

in Acinetobacter baumannii / Antibiotics / Bacteria / Carbapenemase / Care and treatment / cefiderocol / Cephalosporins / critically ill / difficult-to-treat organisms / Drug dosages / Drug resistance / Fermentation / Gram-negative bacilli / Gram-negative bacteria / Gram-positive bacteria / Health aspects / Hospital patients / Infections / Literature reviews / Mechanical ventilation / Mutation / Narratives / Oxygenation / Permeability / Pharmacodynamics / Pharmacokinetics / Plasma / Pseudomonas aeruginosa / Review / Stenotrophomonas maltophilia

2023

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Cefiderocol Treatment for Severe Infections due to Difficult-to-Treat-Resistant Non-Fermentative Gram-Negative Bacilli in ICU Patients: A Case Series and Narrative Literature Review

2023

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Cefiderocol Treatment for Severe Infections due to Difficult-to-Treat-Resistant Non-Fermentative Gram-Negative Bacilli in ICU Patients: A Case Series and Narrative Literature Review

2023

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Journal Article

Cefiderocol Treatment for Severe Infections due to Difficult-to-Treat-Resistant Non-Fermentative Gram-Negative Bacilli in ICU Patients: A Case Series and Narrative Literature Review

Lê, Minh,

Kramer, Laura,

Wicky, Paul-Henri,

Armand-Lefèvre, Laurence,

Timsit, Jean-François,

de Montmollin, Étienne,

Patrier, Juliette,

d’Humières, Camille,

Alves, Manuel,

Poiraud, Joséphine,

Massias, Laurent

2023

Overview

Cefiderocol (FDC) is a siderophore cephalosporin now recognized as a new weapon in the treatment of difficult-to-treat-resistant (DTR) Gram-negative pathogens, including carbapenemase-producing enterobacterales and non-fermentative Gram-negative bacilli (GNB). This article reports our experience with an FDC-based regimen in the treatment of 16 extremely severe patients (invasive mechanical ventilation, 15/16; extracorporeal membrane oxygenation, 9/16; and renal replacement therapy, 8/16) infected with DTR GNB. Our case series provides detailed insight into the pharmacokinetic profile and the microbiological data in real-life conditions. In the narrative review, we discuss the interest of FDC in the treatment of non-fermentative GNB in critically ill patients. We reviewed the microbiological spectrum, resistance mechanisms, pharmacokinetics/pharmacodynamics, efficacy and safety profiles, and real-world evidence for FDC. On the basis of our experience and the available literature, we discuss the optimal FDC-based regimen, FDC dosage, and duration of therapy in critically ill patients with DTR non-fermentative GNB infections.

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Publisher

MDPI AG,MDPI

Subject

Acinetobacter baumannii