Article Dans Une Revue Antibiotics Année : 2025

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

1 Centre Hospitalier Gustave Dron [Tourcoing]
2 Hôpital Avicenne [AP-HP]
3 Service de Maladies Infectieuses et Tropicales [CHU Dijon]
4 Service des Maladies Infectieuses et Tropicales [Lyon]
5 CIRI - Centre International de Recherche en Infectiologie
6 Hôpital Raymond Poincaré [AP-HP]
7 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
8 Service des maladies infectieuses et tropicales [CHU Nantes]
9 CHV - Centre Hospitalier de Valenciennes
10 Service d'infectiologie [CHU Nice]
11 C3M - Centre méditerranéen de médecine moléculaire
12 Services de Maladies Infectieuses et Tropicales [CHU Bichat]
13 INSPIIRE - INterdisciplinarité en Santé Publique Interventions et Instruments de mesure complexes
14 Faculté de Médecine [Nancy]
15 Service des Maladies Infectieuses et Tropicales [CHRU Nancy]
16 CHU Caen Normandie - CHU Caen Normandie – Centre Hospitalier Universitaire de Caen Normandie
17 Centre hospitalier de Troyes
18 CHU Pitié-Salpêtrière [AP-HP]
19 Institut Calot [Fondation Hopale]
20 Hôpital Beaujon [AP-HP]
21 CHU - BREST - Hôpital de la Cavale Blanche - CHRU Brest
22 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
23 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
24 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
25 EA 2694 - Santé Publique : épidémiologie et qualité des soins
26 CH Lorient - Centre Hospitalier de Lorient
27 Hôpital Delafontaine
28 CHU - Centre Hospitalier Universitaire Brugmann [Bruxelles]
29 Pôle Recherche - Département de Pharmacologie Médicale [Lille]
30 CHCB - Centre Hospitalier de la Côte Basque
Messaline Bermejo
Alexandre Bleibtreu

Résumé

Background: 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. Objectives: 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. Methods: We conducted a retrospective observational multicenter study in 22 French centers from January 2019 to December 2023. Results: 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 (n = 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. Conclusions: Our results suggest that CFD may be an alternative in MDR-GNB infections with limited therapeutic options.

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hal-05051899 , version 1 (30-04-2025)

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Ava Diarra, Maxime Degrendel, Isabelle Eberl, Tristan Ferry, Karim Jaffal, et al.. Real-Life Cefiderocol Use in Bone and Joint Infection: A French National Cohort. Antibiotics, 2025, 14 (4), pp.388. ⟨10.3390/antibiotics14040388⟩. ⟨hal-05051899⟩
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