OBJECTIVE: The aim of this study was to report our real-life experience with cefiderocol for the treatment of difficult-to-treat gram-negative infections.

PATIENTS AND METHODS: Patients treated with cefiderocol for at least one day between October 2021 and November 2022 were included following them until 28 days after the end of treatment or death.

RESULTS: Seventeen treatment courses from 16 patients were analyzed (13 males, 3 females). The median age was 69.14 years (35-84). All had a documented gram-negative infection in which cefiderocol was the only treatment option. Nine patients were critical when treatment started (Sequential Organ Failure Assessment = 7.6). The isolated microorganisms were carbapenemase producers, particularly VIM producer Pseudomonas aeruginosa (11 cases) and Serratia marcescens (5 cases, one of them was also KPC producer) and NMD producer Klebsiella oxytoca (1 case). The median treatment duration was 12.4 days (5-27). Clinical cure was achieved in 10 patients, 5 died and 1 achieved clinical cure once its main infection was treated.

CONCLUSIONS: The results of cefiderocol in real life are similar to those reported for the drug in clinical trials. This is one of the largest series of cases published in literature that includes different microorganisms and indications, which might help clinicians when treating this kind of patients.