Efficacy and safety of cefiderocol in the treatment of infections caused by Gram-negative bacteria: a systematic review and meta-analysis.

IF 1.4 4区医学 Q4 INFECTIOUS DISEASES

Journal of Infection in Developing Countries Pub Date : 2024-12-30 DOI:10.3855/jidc.19875

Xiaocui Huang, Lin Su, Wenjie Zhou, Yiduo Zhang, Fan Yu, Chao Li

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引用次数: 0

Abstract

Objective: To assess the efficacy and safety of cefiderocol (CFDC) in the treatment of Gram-negative bacteria (GNB) infections.

Methods: Relevant studies were collected from PubMed, Web of Science, Cochrane, and Embase databases, from inception to 15 October 2023. The search formula was as follow: "cefiderocol", "S-649266", "Gram-Negative Bacteria", "Gram Negative Bacteria", "Klebsiella pneumoniae", "Hyalococcus pneumoniae", and "Bacterium pneumoniae proposal". Stata 15.0 software was employed to pool data with risk ratios (RRs) and 95% confidence intervals (CIs). Data were pooled using a random- or a fixed-effects model.

Results: After a comprehensive study selection, 11 studies (5 RCTs and 7 observational studies) were retrieved that compared the efficacy of CFDC with other regimens, e.g., imipenem/cilastatin. The clinical response (RR = 1.00, 95% CI 0.94-1.08, I2 = 0%) and microbiological response (RR = 0.95 95% CI = 0.80-1.14, I2 = 68.7%) of CFDC were comparable to the control group. No significant differences were observed in mortality and adverse events. Furthermore, subgroup analyses showed that CFDC enhanced microbiological eradication in the follow-up group (RR = 1.25, 95% CI 1.05-1.49) and patients with complicated urinary tract infections (cUTI) (RR = 1.32, 95% CI 1.11- 1.57).

Conclusions: CFDC is a novel iron-carrying cephalosporin with the potential to effectively combat Gram-negative bacterial infections. Additional large and high-quality RCTs are required to further confirm the safety of CFDC.

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头孢地罗治疗革兰氏阴性菌感染的有效性和安全性：系统综述和荟萃分析。

目的：评价头孢地罗（CFDC）治疗革兰氏阴性菌（GNB）感染的疗效和安全性。方法：从PubMed、Web of Science、Cochrane和Embase数据库中收集自成立至2023年10月15日的相关研究。搜索公式为：“cefiderocol”、“S-649266”、“革兰氏阴性菌”、“革兰氏阴性菌”、“肺炎克雷伯菌”、“肺炎透明球菌”、“肺炎杆菌提案”。采用Stata 15.0软件合并风险比（rr）和95%置信区间（ci）数据。数据汇集使用随机或固定效应模型。结果：经过全面的研究选择，检索到11项研究（5项rct和7项观察性研究），比较了CFDC与其他方案（如亚胺培南/西司他汀）的疗效。CFDC组的临床反应（RR = 1.00, 95% CI 0.94 ~ 1.08, I2 = 0%）和微生物反应（RR = 0.95, 95% CI = 0.80 ~ 1.14, I2 = 68.7%）与对照组相当。在死亡率和不良事件方面没有观察到显著差异。此外，亚组分析显示，CFDC促进了随访组（RR = 1.25, 95% CI 1.05-1.49）和并发尿路感染（cUTI）患者（RR = 1.32, 95% CI 1.11- 1.57）的微生物根除。结论：CFDC是一种新型载铁头孢菌素，具有有效对抗革兰氏阴性细菌感染的潜力。需要更多的大型和高质量的随机对照试验来进一步确认CFDC的安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection in Developing Countries INFECTIOUS DISEASES-

CiteScore

3.70

自引率

5.30%

发文量

239

审稿时长

4-8 weeks

期刊介绍： The Journal of Infection in Developing Countries (JIDC) is an international journal, intended for the publication of scientific articles from Developing Countries by scientists from Developing Countries. JIDC is an independent, on-line publication with an international editorial board. JIDC is open access with no cost to view or download articles and reasonable cost for publication of research artcles, making JIDC easily availiable to scientists from resource restricted regions.