| Title: |
P11. Cefiderocol for Gram-negative infections: comparing monotherapy and combination therapy in the multicenter CEFI-BAC study |
| Authors: |
Di Bartolomeo, F; Varisco, B; Bartoletti, M; Bonfanti, P; Borghi, F; Bruno, R; Casari, S; Cattelan, A M; Cauda, R; Codeluppi, M; Cona, A; Coppola, N; Franzetti, M; Fusco, P; Garilli, S; Iaria, C; Meschiari, M; Monari, C; Mularoni, A; Mussini, C; Piconi, S; Pipitone, G; Rizzi, M; Rossi, N; Rusconi, S; Sanguinetti, M; Saracino, A; Scaglione, V; Segala, F V; Tagliaferri, G; Torti, C; Visicaro, M; Marchetti, G C; Gattuso, G |
| Source: |
JAC-Antimicrobial Resistance ; volume 7, issue Supplement_2 ; ISSN 2632-1823 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2025 |
| Description: |
Background Real-life data on cefiderocol for Gram-negative infections remain limited. We aimed to evaluate factors associated with mortality in patients treated with cefiderocol either as monotherapy or combination therapy. Methods A retrospective multicenter study using the CEFI-BAC cohort was conducted across 17 Italian centers on adults treated with cefiderocol (January 2021–February 2023). Data included patient characteristics, infections, prescriptions, end-of-treatment (EOT) outcomes, and mortality (in-hospital/30-days). Statistical comparisons were performed using Chi-square/Fisher’s tests and the Mann-Whitney U test. Factors associated with 30-days mortality were analyzed using multivariate Cox regression. Results Among 243 patients, 65% were male (median age 68 years). Major infections included bloodstream infections (61%, 149/243) and nosocomial pneumonia (14%, 34/243) with Acinetobacter baumannii (64%, 157/243), Pseudomonas aeruginosa (17%, 42/243), and Klebsiella spp. (23%, 57/243) as most common pathogens. Median treatment lasted 10 days (IQR 7–15) with five adverse events reported. Clinical cure at EOT was 59% (143/243). EOT mortality for all patients was 22.5% (50/243), and in- hospital mortality was 40.3% (93/243). Cefiderocol was used in combination therapy in 56% of cases (137/243), mainly for severe infections, including polymicrobial infections (34%, 46/243) and septic shock (27%, 37/243) (Table 1). Monotherapy correlated with higher comorbidity burden. EOT mortality was 17% (18/106) for monotherapy and 23% (32/137) for combination therapy, with no significant differences in in-hospital mortality (36.5%, 35/243 versus 42.9%, 58/243; P = 0.320) or hospitalisation length (40 [IQR 24–72] versus 46 days [IQR 25–76]; P = 0.340). Kaplan-Meier analysis confirmed no significant differences in 30-day mortality (Figure 1). Multivariate Cox regression identified advanced age (aHR: 1.25/year, P = 0.038), prior antibiotics (aHR: 4.31–7.50, P < 0.05), concurrent SARS-CoV-2 infection (aHR: ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/jacamr/dlaf046.011 |
| Availability: |
https://doi.org/10.1093/jacamr/dlaf046.011; https://academic.oup.com/jacamr/article-pdf/7/Supplement_2/dlaf046.011/62997625/dlaf046.011.pdf |
| Rights: |
https://creativecommons.org/licenses/by-nc/4.0/ |
| Accession Number: |
edsbas.1A6738B2 |
| Database: |
BASE |