Infectious Diseases and Therapy (Jul 2024)
Use of Cefiderocol in Adult Patients: Descriptive Analysis from a Prospective, Multicenter, Cohort Study
- Daniele Roberto Giacobbe,
- Laura Labate,
- Chiara Russo Artimagnella,
- Cristina Marelli,
- Alessio Signori,
- Vincenzo Di Pilato,
- Chiara Aldieri,
- Alessandra Bandera,
- Federica Briano,
- Bruno Cacopardo,
- Alessandra Calabresi,
- Federico Capra Marzani,
- Anna Carretta,
- Annamaria Cattelan,
- Luca Ceccarelli,
- Giovanni Cenderello,
- Silvia Corcione,
- Andrea Cortegiani,
- Rosario Cultrera,
- Francesco Giuseppe De Rosa,
- Valerio Del Bono,
- Filippo Del Puente,
- Chiara Fanelli,
- Fiorenza Fava,
- Daniela Francisci,
- Nicholas Geremia,
- Lucia Graziani,
- Andrea Lombardi,
- Angela Raffaella Losito,
- Ivana Maida,
- Andrea Marino,
- Maria Mazzitelli,
- Marco Merli,
- Roberta Monardo,
- Alessandra Mularoni,
- Chiara Oltolini,
- Carlo Pallotto,
- Emanuele Pontali,
- Francesca Raffaelli,
- Matteo Rinaldi,
- Marco Ripa,
- Teresa Antonia Santantonio,
- Francesco Saverio Serino,
- Michele Spinicci,
- Carlo Torti,
- Enrico Maria Trecarichi,
- Mario Tumbarello,
- Malgorzata Mikulska,
- Mauro Giacomini,
- Anna Marchese,
- Antonio Vena,
- Matteo Bassetti,
- CEFI-SITA investigators
Affiliations
- Daniele Roberto Giacobbe
- Department of Health Sciences (DISSAL), University of Genoa
- Laura Labate
- Department of Health Sciences (DISSAL), University of Genoa
- Chiara Russo Artimagnella
- Department of Health Sciences (DISSAL), University of Genoa
- Cristina Marelli
- Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino
- Alessio Signori
- Section of Biostatistics, Department of Health Sciences (DISSAL), University of Genoa
- Vincenzo Di Pilato
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa
- Chiara Aldieri
- Infectious Diseases Unit, S. Croce e Carle Hospital
- Alessandra Bandera
- Department of Pathophysiology and Transplantation, University of Milano
- Federica Briano
- SC Malattie Infettive e Tropicali, Ospedale San Paolo Savona
- Bruno Cacopardo
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania
- Alessandra Calabresi
- AOU SS Antonio, Biagio e Cesare Arrigo di Alessandria
- Federico Capra Marzani
- SC AR1-Terapia Intensiva Generale, Fondazione IRCCS Policlinico San Matteo
- Anna Carretta
- Department of Medical and Surgical Sciences, Infectious Diseases Unit, University of Foggia
- Annamaria Cattelan
- Infectious and Tropical Diseases Unit, Padua University Hospital
- Luca Ceccarelli
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna
- Giovanni Cenderello
- Department of Infectious Diseases, Sanremo Hospital
- Silvia Corcione
- Department of Medical Sciences, Infectious Diseases, University of Turin
- Andrea Cortegiani
- Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo
- Rosario Cultrera
- Department of Translational Medicine, University of Ferrara
- Francesco Giuseppe De Rosa
- Department of Medical Sciences, Infectious Diseases, University of Turin
- Valerio Del Bono
- Infectious Diseases Unit, S. Croce e Carle Hospital
- Filippo Del Puente
- Department of Infectious Diseases, Galliera Hospital
- Chiara Fanelli
- Department of Medicine, Surgery and Pharmacy, University of Sassari
- Fiorenza Fava
- Anestesia e Terapia Intensiva Cardiotoracica, Fondazione IRCCS Policlinico San Matteo
- Daniela Francisci
- Infectious Diseases Clinic, Santa Maria della Misericordia Hospital, Department of Medicine and Surgery, University of Perugia
- Nicholas Geremia
- Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale “dell’Angelo”
- Lucia Graziani
- Department of Experimental and Clinical Medicine, University of Florence
- Andrea Lombardi
- Department of Pathophysiology and Transplantation, University of Milano
- Angela Raffaella Losito
- Dipartimento di Scienze Mediche e Chirurgiche, UOC Malattie Infettive, Fondazione Policlinico Universitario Agostino Gemelli IRCCS
- Ivana Maida
- Department of Medicine, Surgery and Pharmacy, University of Sassari
- Andrea Marino
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania
- Maria Mazzitelli
- Infectious and Tropical Diseases Unit, Padua University Hospital
- Marco Merli
- ASST Grande Ospedale Metropolitano Niguarda
- Roberta Monardo
- Università Vita-Salute San Raffaele
- Alessandra Mularoni
- IRCCS-ISMETT
- Chiara Oltolini
- ASST Grande Ospedale Metropolitano Niguarda
- Carlo Pallotto
- Infectious Diseases Clinic, Santa Maria della Misericordia Hospital, Department of Medicine and Surgery, University of Perugia
- Emanuele Pontali
- Department of Infectious Diseases, Galliera Hospital
- Francesca Raffaelli
- Dipartimento di Scienze Mediche e Chirurgiche, UOC Malattie Infettive, Fondazione Policlinico Universitario Agostino Gemelli IRCCS
- Matteo Rinaldi
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna
- Marco Ripa
- Università Vita-Salute San Raffaele
- Teresa Antonia Santantonio
- Department of Medical and Surgical Sciences, Infectious Diseases Unit, University of Foggia
- Francesco Saverio Serino
- Azienda ULSS4 Veneto Orientale, UOS Malattie Infettive, UOC Medicina Generale Portogruaro
- Michele Spinicci
- Department of Experimental and Clinical Medicine, University of Florence
- Carlo Torti
- Dipartimento di Scienze Mediche e Chirurgiche, UOC Malattie Infettive, Fondazione Policlinico Universitario Agostino Gemelli IRCCS
- Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, University “Magna Graecia”
- Mario Tumbarello
- Department of Medical Biotechnologies, University of Siena
- Malgorzata Mikulska
- Department of Health Sciences (DISSAL), University of Genoa
- Mauro Giacomini
- Department of Informatics, Bioengineering, Robotics and System Engineering (DIBRIS), University of Genoa
- Anna Marchese
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa
- Antonio Vena
- Department of Health Sciences (DISSAL), University of Genoa
- Matteo Bassetti
- Department of Health Sciences (DISSAL), University of Genoa
- CEFI-SITA investigators
- DOI
- https://doi.org/10.1007/s40121-024-01016-y
- Journal volume & issue
-
Vol. 13,
no. 9
pp. 1929 – 1948
Abstract
Abstract Introduction 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. Methods In this multicenter, prospective study, we aimed at describing the use of cefiderocol in terms of types of therapy, indications, and patient characteristics. Results 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. Conclusions 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.
Keywords
