Treatment of Carbapenem-Resistant <i>Acinetobacter baumannii</i> in Real Life (T-ACI): A Prospective Single-Center Observational Study

<b>Background:</b> Carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAB) poses significant challenges in healthcare due to its multidrug resistance and high mortality rates among critically ill patients. <b>Results:</b> We enrolled 45 patients. Cefiderocol wa...

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Main Authors: Antonio Riccardo Buonomo, Riccardo Scotto, Nunzia Esposito, Giulio Viceconte, Nicola Schiano Moriello, Giulia Zumbo, Ilaria Vecchietti, Amedeo Lanzardo, Carmine Iacovazzo, Francesco Curcio, Emanuela Roscetto, Ivan Gentile
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Language:English
Published: MDPI AG 2024-10-01
Series:Antibiotics
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Online Access:https://www.mdpi.com/2079-6382/13/11/1007
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author Antonio Riccardo Buonomo
Riccardo Scotto
Nunzia Esposito
Giulio Viceconte
Nicola Schiano Moriello
Giulia Zumbo
Ilaria Vecchietti
Amedeo Lanzardo
Carmine Iacovazzo
Francesco Curcio
Emanuela Roscetto
Ivan Gentile
author_facet Antonio Riccardo Buonomo
Riccardo Scotto
Nunzia Esposito
Giulio Viceconte
Nicola Schiano Moriello
Giulia Zumbo
Ilaria Vecchietti
Amedeo Lanzardo
Carmine Iacovazzo
Francesco Curcio
Emanuela Roscetto
Ivan Gentile
author_sort Antonio Riccardo Buonomo
collection DOAJ
description <b>Background:</b> Carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAB) poses significant challenges in healthcare due to its multidrug resistance and high mortality rates among critically ill patients. <b>Results:</b> We enrolled 45 patients. Cefiderocol was administered to 40% of patients, often (38.8%) in combination with other antibiotics. Colistin was administered to 60% of patients and always in combination, mostly with ampicillin–sulbactam. The overall ECS and OCS rates were 77.8% and 66.7%, respectively. Patients treated with an initial cefiderocol-based regimen showed a higher rate of ECS compared with patients initially treated with colistin-based regimens (100% vs. 63%, <i>p</i> < 0.05). Patients treated with cefiderocol alone showed a higher rate of ECS compared with patients treated with cefiderocol-based regimens (100% vs. 70.6%, <i>p</i> < 0.05). No differences in OCS rates were recorded depending on the treatment received. Additionally, cefiderocol regimens were associated with fewer ADRs compared to colistin-based treatment. <b>Methods:</b> This prospective observational study enrolled patients with CRAB infections from January 2022 to August 2023. Patients were treated with cefiderocol-based or colistin-based regimens and were monitored for 28 days to assess early clinical success (ECS), overall clinical success (OCS) and adverse drug reactions (ADRs). <b>Conclusions:</b> This study highlights the potential advantages of cefiderocol, even used as a monotherapy, in treating CRAB, especially when early clinical and laboratory response was assessed. This research contributes to the ongoing discussion on the most effective and safe treatments for combating CRAB infections, supporting the use of cefiderocol in clinical practice.
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spelling doaj-art-d86fc7d293724dab869b2477076ad6c42024-11-26T17:46:20ZengMDPI AGAntibiotics2079-63822024-10-011311100710.3390/antibiotics13111007Treatment of Carbapenem-Resistant <i>Acinetobacter baumannii</i> in Real Life (T-ACI): A Prospective Single-Center Observational StudyAntonio Riccardo Buonomo0Riccardo Scotto1Nunzia Esposito2Giulio Viceconte3Nicola Schiano Moriello4Giulia Zumbo5Ilaria Vecchietti6Amedeo Lanzardo7Carmine Iacovazzo8Francesco Curcio9Emanuela Roscetto10Ivan Gentile11Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, 80131 Naples, ItalyDepartment of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, 80131 Naples, ItalyDepartment of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, 80131 Naples, ItalyDepartment of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, 80131 Naples, ItalyDepartment of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, 80131 Naples, ItalyDepartment of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, 80131 Naples, ItalyDepartment of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, 80131 Naples, ItalyDepartment of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, 80131 Naples, ItalyDepartment of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, ItalyDepartment of Translational Medical Sciences, University of Naples Federico II, 80138 Naples, ItalyDepartment Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, ItalyDepartment of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, 80131 Naples, Italy<b>Background:</b> Carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAB) poses significant challenges in healthcare due to its multidrug resistance and high mortality rates among critically ill patients. <b>Results:</b> We enrolled 45 patients. Cefiderocol was administered to 40% of patients, often (38.8%) in combination with other antibiotics. Colistin was administered to 60% of patients and always in combination, mostly with ampicillin–sulbactam. The overall ECS and OCS rates were 77.8% and 66.7%, respectively. Patients treated with an initial cefiderocol-based regimen showed a higher rate of ECS compared with patients initially treated with colistin-based regimens (100% vs. 63%, <i>p</i> < 0.05). Patients treated with cefiderocol alone showed a higher rate of ECS compared with patients treated with cefiderocol-based regimens (100% vs. 70.6%, <i>p</i> < 0.05). No differences in OCS rates were recorded depending on the treatment received. Additionally, cefiderocol regimens were associated with fewer ADRs compared to colistin-based treatment. <b>Methods:</b> This prospective observational study enrolled patients with CRAB infections from January 2022 to August 2023. Patients were treated with cefiderocol-based or colistin-based regimens and were monitored for 28 days to assess early clinical success (ECS), overall clinical success (OCS) and adverse drug reactions (ADRs). <b>Conclusions:</b> This study highlights the potential advantages of cefiderocol, even used as a monotherapy, in treating CRAB, especially when early clinical and laboratory response was assessed. This research contributes to the ongoing discussion on the most effective and safe treatments for combating CRAB infections, supporting the use of cefiderocol in clinical practice.https://www.mdpi.com/2079-6382/13/11/1007<i>Acinetobacter baumannii</i>CRABcefiderocolcolistin
spellingShingle Antonio Riccardo Buonomo
Riccardo Scotto
Nunzia Esposito
Giulio Viceconte
Nicola Schiano Moriello
Giulia Zumbo
Ilaria Vecchietti
Amedeo Lanzardo
Carmine Iacovazzo
Francesco Curcio
Emanuela Roscetto
Ivan Gentile
Treatment of Carbapenem-Resistant <i>Acinetobacter baumannii</i> in Real Life (T-ACI): A Prospective Single-Center Observational Study
Antibiotics
<i>Acinetobacter baumannii</i>
CRAB
cefiderocol
colistin
title Treatment of Carbapenem-Resistant <i>Acinetobacter baumannii</i> in Real Life (T-ACI): A Prospective Single-Center Observational Study
title_full Treatment of Carbapenem-Resistant <i>Acinetobacter baumannii</i> in Real Life (T-ACI): A Prospective Single-Center Observational Study
title_fullStr Treatment of Carbapenem-Resistant <i>Acinetobacter baumannii</i> in Real Life (T-ACI): A Prospective Single-Center Observational Study
title_full_unstemmed Treatment of Carbapenem-Resistant <i>Acinetobacter baumannii</i> in Real Life (T-ACI): A Prospective Single-Center Observational Study
title_short Treatment of Carbapenem-Resistant <i>Acinetobacter baumannii</i> in Real Life (T-ACI): A Prospective Single-Center Observational Study
title_sort treatment of carbapenem resistant i acinetobacter baumannii i in real life t aci a prospective single center observational study
topic <i>Acinetobacter baumannii</i>
CRAB
cefiderocol
colistin
url https://www.mdpi.com/2079-6382/13/11/1007
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