Real-life impact of cefiderocol in carbapenem-resistant Acinetobacter baumannii infections (CRAb): a narrative review.

IF 2.7 3区医学 Q3 PHARMACOLOGY & PHARMACY

European Journal of Clinical Pharmacology Pub Date : 2025-09-01 Epub Date: 2025-06-12 DOI:10.1007/s00228-025-03866-y

Francesco Ferrara, Lorenzo Martellone, Marcello Vaccaro, Adriana Coluccia, Manlio Scognamiglio, Roberto Langella, Andrea Zovi, Giacomo Polito

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引用次数: 0

Abstract

Introduction: Healthcare-associated infections (HAIs) represent one of the most serious complications in medical care, with a substantial global burden. The emergence and spread of antibiotic resistance, particularly among multidrug-resistant organisms such as carbapenem-resistant Acinetobacter baumannii (CRAb), have significantly complicated infection management.

Objectives: The aim of this review is to provide an updated perspective on its clinical use and to explore novel therapeutic strategies for combating multidrug-resistant bacterial infections.

Methods: A narrative review was performed in accordance with PRISMA 2020 guidelines, including real-world, comparative, and longitudinal observational studies that assessed cefiderocol efficacy, safety, and associated clinical outcomes.

Results: The findings suggest that cefiderocol is a promising therapeutic agent for CRAb infections, demonstrating lower mortality rates compared to colistin-based regimens. Comparative studies also report a superior safety profile, particularly regarding reduced nephrotoxicity. Cefiderocol unique siderophore-mediated mechanism facilitates efficient bacterial uptake, enabling activity even against carbapenem-resistant strains.

Conclusions: Although emerging evidence supports cefiderocol efficacy and safety, concerns persist about the potential for resistance development. Further randomized controlled trials are needed to clarify its role in the daily clinical practice and establish definitive treatment guidelines. In this context, the inclusion of reference intervals for resistance emergence during therapy is recommended, underscoring the need for vigilant monitoring throughout treatment.

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头孢地洛尔对耐碳青霉烯鲍曼不动杆菌感染（CRAb）的现实影响：一篇叙述性综述。

导言：医疗保健相关感染（HAIs）是医疗保健中最严重的并发症之一，具有巨大的全球负担。抗生素耐药性的出现和传播，特别是在耐碳青霉烯鲍曼不动杆菌（CRAb）等多重耐药生物中，使感染管理变得非常复杂。目的：本文综述的目的是提供其临床应用的最新观点，并探索对抗多药耐药细菌感染的新治疗策略。方法：根据PRISMA 2020指南进行叙述性回顾，包括真实世界、比较和纵向观察性研究，评估头孢地罗的疗效、安全性和相关临床结果。结果：研究结果表明，头孢地罗是一种很有前景的治疗螃蟹感染的药物，与以粘菌素为基础的方案相比，其死亡率更低。比较研究也报告了优越的安全性，特别是在降低肾毒性方面。Cefiderocol独特的铁载体介导机制促进了细菌的有效摄取，甚至对碳青霉烯耐药菌株也具有活性。结论：尽管新出现的证据支持头孢地罗的有效性和安全性，但对耐药性发展的潜在担忧仍然存在。需要进一步的随机对照试验来阐明其在日常临床实践中的作用，并建立明确的治疗指南。在这种情况下，建议纳入治疗期间出现耐药性的参考区间，强调在整个治疗过程中需要进行警惕监测。

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

European Journal of Clinical Pharmacology 医学-药学

CiteScore

5.40

自引率

3.40%

发文量

170

审稿时长

3-8 weeks

期刊介绍： The European Journal of Clinical Pharmacology publishes original papers on all aspects of clinical pharmacology and drug therapy in humans. Manuscripts are welcomed on the following topics: therapeutic trials, pharmacokinetics/pharmacodynamics, pharmacogenetics, drug metabolism, adverse drug reactions, drug interactions, all aspects of drug development, development relating to teaching in clinical pharmacology, pharmacoepidemiology, and matters relating to the rational prescribing and safe use of drugs. Methodological contributions relevant to these topics are also welcomed. Data from animal experiments are accepted only in the context of original data in man reported in the same paper. EJCP will only consider manuscripts describing the frequency of allelic variants in different populations if this information is linked to functional data or new interesting variants. Highly relevant differences in frequency with a major impact in drug therapy for the respective population may be submitted as a letter to the editor. Straightforward phase I pharmacokinetic or pharmacodynamic studies as parts of new drug development will only be considered for publication if the paper involves -a compound that is interesting and new in some basic or fundamental way, or -methods that are original in some basic sense, or -a highly unexpected outcome, or -conclusions that are scientifically novel in some basic or fundamental sense.