Real-Life Cefiderocol Use in Bone and Joint Infection: A French National Cohort

<b>Background</b>: Cefiderocol (CFD) is a novel siderophore cephalosporin developed for the treatment of infections involving multidrug-resistant (MDR) Gram-negative bacilli (GNB) infections (1-3). For bone and joint infections (BJIs), the use of CFD is currently neither part of its market authorization nor recommended, and has not yet been assessed by large-scale studies. <b>Objectives</b>: To fill the scarcity of data regarding the use of CFD in BJIs, we aimed to describe patients' and infection characteristics along with the outcomes of the infection. <b>Methods</b>: We conducted a retrospective observational multicenter study in 22 French centers from January 2019 to December 2023. <b>Results</b>: From January 2019 to December 2023, 45 patients were included. Patients were mainly males (73%) with a median age of 62 years (interquartile range [IQR] 29), and a median Charlson comorbidity index of 3. Implant-related infections (20) were the most prominent, accounting for 44% of the cases. Carbapenemase-producing GNB were involved in 74% of the cases (<i>n</i> = 17/23), among which Pseudomonas aeruginosa accounted for 38% of these cases. Most patients received 6 g of CFD per day. CFD was used in combination with an antibiotic in 40 out of 45 cases (89%). The median duration of CFD treatment was 34 days. Seven patients (16%) experienced side effects, mainly gastro-intestinal disorders, including three (7%) who induced treatment cessation. Infection control included surgery in 37 (82%) patients. Failures and deaths occurred, respectively, in 22 (49%) and 10 (22%) cases. <b>Conclusions</b>: Our results suggest that CFD may be an alternative in MDR-GNB infections with limited therapeutic options.

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Publication Details

Journal
Antibiotics
Published
2025-04-08
DOI
https://doi.org/10.3390/antibiotics14040388
Citations
3
Primary Topic
Antibiotic Resistance in Bacteria
Type
article
Field-Weighted Citation Impact
1.77

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article

Real-Life Cefiderocol Use in Bone and Joint Infection: A French National Cohort

V. Dacquet, Tristan Ferry, Pierre Gazeau, Benjamin Lefèvre et al.
3 citations
Antibiotics
Antibiotic Resistance in Bacteria
1.77
article

Real-Life Cefiderocol Use in Bone and Joint Infection: A French National Cohort

V. Dacquet, Tristan Ferry, Pierre Gazeau, Benjamin Lefèvre, Romaric Larcher, Victoire de Lastours, Éric Senneville, Ava Diarra, L. Escaut, N. Sayre, Johan Courjon, Aurélie Baldolli, Antoine Khati, N. Rouzic, Isabelle Eberl, Messaline Bermejo, H. Wille, Benjamín Valentín, Pierre Patoz, Diana Isabela Costescu Strachinaru, Alexandre Bleibtreu, Olivier Robineau, Nicolas Taar, Maxime Degrendel, Laurène Deconinck, Karim Jaffal
article en
3 citations

Abstract

<b>Background</b>: Cefiderocol (CFD) is a novel siderophore cephalosporin developed for the treatment of infections involving multidrug-resistant (MDR) Gram-negative bacilli (GNB) infections (1-3). For bone and joint infections (BJIs), the use of CFD is currently neither part of its market authorization nor recommended, and has not yet been assessed by large-scale studies. <b>Objectives</b>: To fill the scarcity of data regarding the use of CFD in BJIs, we aimed to describe patients' and infection characteristics along with the outcomes of the infection. <b>Methods</b>: We conducted a retrospective observational multicenter study in 22 French centers from January 2019 to December 2023. <b>Results</b>: From January 2019 to December 2023, 45 patients were included. Patients were mainly males (73%) with a median age of 62 years (interquartile range [IQR] 29), and a median Charlson comorbidity index of 3. Implant-related infections (20) were the most prominent, accounting for 44% of the cases. Carbapenemase-producing GNB were involved in 74% of the cases (<i>n</i> = 17/23), among which Pseudomonas aeruginosa accounted for 38% of these cases. Most patients received 6 g of CFD per day. CFD was used in combination with an antibiotic in 40 out of 45 cases (89%). The median duration of CFD treatment was 34 days. Seven patients (16%) experienced side effects, mainly gastro-intestinal disorders, including three (7%) who induced treatment cessation. Infection control included surgery in 37 (82%) patients. Failures and deaths occurred, respectively, in 22 (49%) and 10 (22%) cases. <b>Conclusions</b>: Our results suggest that CFD may be an alternative in MDR-GNB infections with limited therapeutic options.

AntibioticsVol. 14(4)
Université Claude Bernard Lyon 1 (FR), École Normale Supérieure de Lyon (FR), Centre National de la Recherche Scientifique (FR), Inserm (FR), Université de Montpellier (FR), Université Côte d'Azur (FR), Université Paris Cité (FR), Université de Lille (FR), Hôpital Beaujon (FR), Centre Hospitalier Universitaire de Nice (FR), Centre Hospitalier Universitaire de Nantes (FR), Sorbonne Université (FR), Assistance Publique – Hôpitaux de Paris (FR), Centre Hospitalier de Bretagne Sud (FR), Hospices Civils de Lyon (FR), Fondation Hopale (FR), Queen Astrid Military Hospital (BE), Centre Hospitalier Universitaire de Caen Normandie (FR), Centre Hospitalier de Tourcoing (FR), Centre Méditerranéen de Médecine Moléculaire (FR), Pitié-Salpêtrière Hospital (FR), Centre Hospitalier de Troyes (FR), Centre Hospitalier de la Côte Basque (FR), Hôpital Avicenne (FR), Institut Pierre Louis d‘Épidémiologie et de Santé Publique (FR), Hôpital Raymond-Poincaré (FR), Hôpital Bichat-Claude-Bernard (FR), Centre Hospitalier Saint-Denis (FR), Centre Hospitalier de Valenciennes (FR), Centre International de Recherche en Infectiologie (FR), Bicêtre Hospital (FR), Hôpital Maison Blanche (FR), Interdisciplinarité en Santé Publique Interventions et Instruments de mesure complexes – Région Est (FR), Université de Nîmes (FR), Université de Lorraine (FR), Université de Caen Normandie (FR)
Shionogi
Good health and well-being
Openalex Percentile: Top 16%
Antibiotic Resistance in Bacteria
1.77
DOIOpen Access PDFOpenAlex
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