Cefiderocol in Difficult-to-Treat Nf-GNB in ICU Settings.
Charles-Hervé VacheronAnne KaasJean-Philippe RasigadeFrederic AubrunLaurent ArgaudBaptiste BalancaJean-Luc FellahiJean Christophe RichardAnne-Claire LukaszewiczFlorent WalletOlivier DauwalderArnaud FriggeriPublished in: Annals of intensive care (2024)
We included 27 patients with cefiderocol, matched with 54 patients receiving the BAT. Four patients were not exactly matched on the type of ICU unit. Characteristics were comparable between groups, mostly male with a Charlson Comorbidity Index of 3 [1-5], and 28% had immunosuppression. Cefiderocol patients were most likely to have higher number of antibiotic lines. The main DTR Nf-GNB identified was Pseudomonas aeruginosa (81.5%), followed by Acinetobater baumanii (14.8%) and Stenotrophomonas maltophilia (3.7%). Pneumonia was the identified infection in 21 (78.8%) patients in the Cefiderocol group and in 51 (94.4%) patients in the BAT group (p = 0.054). Clinical cure at 15 and 30-day and the in-ICU mortality was comparable between groups, however relapse was higher in the cefiderocol group (8-29.6% vs. 4-7.4%;aOR 10.06[1.96;51.53]) CONCLUSION: Cefiderocol did not show an improvement in clinical cure or mortality rates compared to BAT in the treatment of DTR Nf-GNB, but it was associated with a higher relapse rate.
Keyphrases
- end stage renal disease
- newly diagnosed
- chronic kidney disease
- ejection fraction
- pseudomonas aeruginosa
- peritoneal dialysis
- signaling pathway
- intensive care unit
- prognostic factors
- gram negative
- oxidative stress
- type diabetes
- cardiovascular disease
- cystic fibrosis
- coronary artery disease
- cardiovascular events
- escherichia coli
- patient reported outcomes
- risk factors
- free survival
- replacement therapy
- acinetobacter baumannii