Cefiderocol-containing regimens for the treatment of carbapenem-resistant


Journal

JAC-antimicrobial resistance
ISSN: 2632-1823
Titre abrégé: JAC Antimicrob Resist
Pays: England
ID NLM: 101765283

Informations de publication

Date de publication:
Aug 2023
Historique:
received: 12 04 2023
accepted: 27 06 2023
medline: 24 7 2023
pubmed: 24 7 2023
entrez: 24 7 2023
Statut: epublish

Résumé

Cefiderocol is a novel β-lactam with activity against carbapenem-resistant To assess the association between cefiderocol-containing regimens treatment and 28-day mortality in carbapenem-resistant An observational cohort study including critically ill COVID-19 patients with CRAB-VAP admitted to two ICUs of a large academic hospital in Rome between September 2020 and December 2022. The primary outcome was 28-day all-cause mortality. A propensity score was created to balance the cefiderocol- and non-cefiderocol-containing groups. A propensity-weighted multiple logistic regression model was calculated to evaluate risk factors for 28-day mortality. Survival curves were calculated using the Kaplan-Meier method. 121 patients were enrolled, 55 were treated with cefiderocol- and 66 with non-cefiderocol-containing regimens. The 28-day all-cause mortality was 56% (68/121). A statistically significant difference in 28-day mortality was found between cefiderocol- and non-cefiderocol- containing regimens groups (44% versus 67%, Cefiderocol-containing regimens were associated with reduced 28-day mortality in CRAB-VAP. The sample size and the observational design limit the study's conclusions. Future RCTs are needed to establish cefiderocol's definite role in these infections.

Sections du résumé

Background UNASSIGNED
Cefiderocol is a novel β-lactam with activity against carbapenem-resistant
Objectives UNASSIGNED
To assess the association between cefiderocol-containing regimens treatment and 28-day mortality in carbapenem-resistant
Methods UNASSIGNED
An observational cohort study including critically ill COVID-19 patients with CRAB-VAP admitted to two ICUs of a large academic hospital in Rome between September 2020 and December 2022. The primary outcome was 28-day all-cause mortality. A propensity score was created to balance the cefiderocol- and non-cefiderocol-containing groups. A propensity-weighted multiple logistic regression model was calculated to evaluate risk factors for 28-day mortality. Survival curves were calculated using the Kaplan-Meier method.
Results UNASSIGNED
121 patients were enrolled, 55 were treated with cefiderocol- and 66 with non-cefiderocol-containing regimens. The 28-day all-cause mortality was 56% (68/121). A statistically significant difference in 28-day mortality was found between cefiderocol- and non-cefiderocol- containing regimens groups (44% versus 67%,
Conclusion UNASSIGNED
Cefiderocol-containing regimens were associated with reduced 28-day mortality in CRAB-VAP. The sample size and the observational design limit the study's conclusions. Future RCTs are needed to establish cefiderocol's definite role in these infections.

Identifiants

pubmed: 37484029
doi: 10.1093/jacamr/dlad085
pii: dlad085
pmc: PMC10359102
doi:

Types de publication

Journal Article

Langues

eng

Pagination

dlad085

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.

Références

Antibiotics (Basel). 2022 May 27;11(6):
pubmed: 35740130
Clin Infect Dis. 2019 Nov 13;69(Suppl 7):S544-S551
pubmed: 31724049
Antimicrob Agents Chemother. 2022 May 17;66(5):e0214221
pubmed: 35311522
Chest. 2008 Aug;134(2):281-287
pubmed: 18682456
Antibiotics (Basel). 2023 Jan 09;12(1):
pubmed: 36671325
Drugs. 2021 Sep;81(13):1559-1571
pubmed: 34427896
Antibiotics (Basel). 2023 Apr 13;12(4):
pubmed: 37107108
Am J Infect Control. 2019 Sep;47(9):1140-1145
pubmed: 31003750
J Infect. 2019 Aug;79(2):130-138
pubmed: 31145911
Clin Infect Dis. 2016 Sep 1;63(5):e61-e111
pubmed: 27418577
J Antimicrob Chemother. 2019 Jul 1;74(7):1971-1974
pubmed: 31220260
Microbiol Spectr. 2021 Dec 22;9(3):e0069521
pubmed: 34756067
Shock. 2010 Jun;33(6):590-601
pubmed: 19953007
Clin Infect Dis. 2021 Jun 1;72(11):2021-2024
pubmed: 32941593
Lancet Infect Dis. 2021 Feb;21(2):226-240
pubmed: 33058795
J Antimicrob Chemother. 2022 May 29;77(6):1662-1669
pubmed: 35289853
Expert Rev Anti Infect Ther. 2022 May;20(5):707-719
pubmed: 34937518
Lancet Infect Dis. 2021 May;21(5):597-598
pubmed: 33894839
Antimicrob Resist Infect Control. 2022 May 21;11(1):74
pubmed: 35598032
Clin Microbiol Infect. 2022 Apr;28(4):521-547
pubmed: 34923128
Antibiotics (Basel). 2021 May 07;10(5):
pubmed: 34067186
Chest. 2002 Jul;122(1):262-8
pubmed: 12114368
Clin Infect Dis. 2022 Jul 6;74(12):2089-2114
pubmed: 34864936
Crit Care. 2020 Jun 5;24(1):289
pubmed: 32503590
Nephron Clin Pract. 2012;120(4):c179-84
pubmed: 22890468
J Glob Antimicrob Resist. 2020 Dec;23:292-296
pubmed: 33065329
Antibiotics (Basel). 2021 Dec 21;11(1):
pubmed: 35052880
Lancet Infect Dis. 2018 Mar;18(3):318-327
pubmed: 29276051
JAC Antimicrob Resist. 2021 Nov 17;3(4):dlab174
pubmed: 34806011
Lancet Infect Dis. 2019 Jan;19(1):56-66
pubmed: 30409683

Auteurs

Emanuele Rando (E)

Dipartimento di Sicurezza e Bioetica-Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy.

Salvatore Lucio Cutuli (SL)

Dipartimento di Scienza dell'Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.

Flavio Sangiorgi (F)

Dipartimento di Sicurezza e Bioetica-Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy.

Eloisa Sofia Tanzarella (ES)

Dipartimento di Scienza dell'Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.

Francesca Giovannenze (F)

Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.

Giulia De Angelis (G)

Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.
Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.

Rita Murri (R)

Dipartimento di Sicurezza e Bioetica-Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy.
Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.

Massimo Antonelli (M)

Dipartimento di Scienza dell'Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.
Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.

Massimo Fantoni (M)

Dipartimento di Sicurezza e Bioetica-Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy.
Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.

Gennaro De Pascale (G)

Dipartimento di Scienza dell'Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.
Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.

Classifications MeSH