Re: ‘Real world clinical outcome of cefiderocol for treatment of multidrug-resistant nonfermenting gram-negative bacilli infections' by Hoellinger et al.

Abstract

We read with deep interest the letter by Hoellinger and colleagues [ [1] Hoellinger B. Simand C. Jeannot K. Garijo C. Cristinar M. Reisz F. et al. Real-world clinical outcome of cefiderocol for treatment of multidrug-resistant non-fermenting, gram negative bacilli infections: a case series. Clin Microbiol Infect. 2022; (S1198743X22005717)https://doi.org/10.1016/j.cmi.2022.11.005 Abstract Full Text Full Text PDF Google Scholar ] in which the outcomes of ten patients treated with cefiderocol for multidrug-resistant (MDR) non-fermenting gram-negative bacilli (NFGNB) infections were reported. In this work, patients treated by cefiderocol exhibited dramatically high 30-day mortality, clinical failure and microbiological failure rates at 60%, 80% and 60%, respectively. The authors stated that the high rate of treatment failure could be explained by a delayed effective antimicrobial therapy in most of the patients (8/10), the risk of error in cefiderocol susceptibility assessment, the high rate of heteroresistance to cefiderocol, and the high proportion of bloodstream infections (BSI) and immunocompromised patients. Real-world clinical outcome of cefiderocol for treatment of multidrug-resistant non-fermenting, gram negative bacilli infections: a case seriesClinical Microbiology and InfectionPreviewCefiderocol is a new siderophore cephalosporin which represents a later option for the treatment of multi-drug–resistant, gram-negative infections, especially in the case of resistance to the new combinations of β-lactam and β-lactamase. Real-life data on the use of cefiderocol for the treatment of severe multi-drug–resistant, non-fermenting, gram-negative bacilli (NFGNB) infections are scarce. Full-Text PDF