Abstract
Cefiderocol use in A. baumannii pneumonia still represents an important matter of debate. The aim of this study is to describe 13 cases of carbapenem-resistant A. baumannii (CRAB) pneumonia treated with cefiderocol in real-life practice. We retrospectively included patients with CRAB pneumonia hospitalized at Fondazione Policlinico Universitario Agostino Gemelli Hospital treated with cefiderocol either in the general ward or the intensive care unit. A total of 11 patients out of 13 had ventilator-associated pneumonia caused by CRAB, and 12/13 patients had polymicrobial infection. We found a 30-day success rate of 54%. Cefiderocol may have a role when facing severe XDR A. baumannii pneumonia. Future studies are warranted to better define its place in therapy in CRAB infections.
Highlights
Carbapenem-resistant Gram-negative bacteria (GNB) continue to represent a major public health issue worldwide [1], posing an increasing burden in terms of morbidity and mortality in several areas of the world [2] and, in Europe, Italy ranks among the most affected countries [3]
A total of 14 patients treated with cefiderocol for severe, polymicrobial pneumonia were included in the study (Table 1)
Among the two patients hospitalized for reasons not related to COVID-19, one had idiopathic pulmonary fibrosis, and the other suffered from recurrent bacterial pneumonia
Summary
Carbapenem-resistant Gram-negative bacteria (GNB) continue to represent a major public health issue worldwide [1], posing an increasing burden in terms of morbidity and mortality in several areas of the world [2] and, in Europe, Italy ranks among the most affected countries [3]. Cefiderocol, a siderophore cephalosporin, has demonstrated in vitro and in vivo activity against a broad range of Gram-negative bacteria [10,11] Despite these promising results, a limited number of studies has been conducted so far, and its place in therapy is not well-established yet, especially in ventilator-associated pneumonia [12] and polymicrobial infections. A limited number of studies has been conducted so far, and its place in therapy is not well-established yet, especially in ventilator-associated pneumonia [12] and polymicrobial infections In this case series, we aim to illustrate our experience with cefiderocol in patients with HAV/VAP due to carbapenem-resistant A. baumannii
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