Table 1.
Description of Burn Intensive Care Unit Carbapenem-Resistant Acinetobacter baumannii Infection Cases Treated With Cefiderocol
| Patient Number | Age/Sex | TBSA | ABSI | APACHE II Scores | Infection Type(s) | FDC MIC (Cumulative Days of Treatment)a | Prior Antibiotic Failure | FDC Regimen (Duration of Treatment, days) | Combination Therapyb (Duration of Treatment, days) | RRT (Effluent Flow Rate, L/Hour) | Clinical Success at 30 Days | Microbiologic Failure Within 90 Days (Days After Treatment Initiation) | Hospital Disposition (Days After Treatment Initiation) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 48/F | 50.5% | 11 | 19 | BSI | 0.5 (10), >32 (20) | Yes | 2 g q8h (10) | Polymyxin B (7) | No | Yes | Respiratory colonization (17) Relapse VAP (56) | Discharged (72), Readmit (82) |
| 2 | 48/M | 70% | 12 | 19 | BSI | 0.5 (12), 2 (20), 2 (26) | No | 2 g q6h (12) | No | No | No | Relapse VAP (19) | Discharged (76) |
| 3 | 18/F | 80.5% | 12 | 24 | VAP/BSI | - | No | 1.5 g q12h (3)c | No | CVVHDF (2.5) | No | Indeterminated | Expired (3) |
| 4 | 19/F | 61% | 11 | 22 | BSI | 0.5 (0) | No | 2 g q6h (8) | No | No | Yes | No | Discharged (37) |
| 5 | 37/M | 68.5% | 10 | 27 | VAP/BSI | >32 (0), >32 (17) | No | 1.5 g q12h (21)c | No | CVVHDF (2.5) | No | Indeterminated | Expired (21) |
| 6 | 65/F | 42% | 12 | 13 | BSI | 1 (0), 0.25 (11) | No | 750 mg q12h (11) | No | IHD | Yes | Respiratory colonization (70) | Discharged (182) |
| 7 | 19/M | 42.5% | 8 | 27 | VAP | >32 (0), >32 (13) | No | 2 g q6h (13) | No | No | No | Respiratory colonization (21) | Discharged (75) |
| 8 | 57/F | 100%e | 3f | 36 | BSI | >32 (0) | No | 1.5 g q8h (9)c | Polymyxin B (8) | CVVHDF (4) | No | Indeterminated | Expired (9) |
| 9 | 62/M | 41% | 11 | 24 | VAT | >32 (7) | No | 2 g q8h (7) | Polymyxin B (7) | No | Yes | Respiratory colonization (16) | Discharged (56) |
| 10 | 39/M | 31.5% | 8 | 17 | VAP/BSI | >32 (0), >32 (8) | No | 2 g q8h (8) | No | No | No | Relapse BSI (11) | Discharged (46) |
| 11 | 37/M | 71% | 12 | 32 | VAP/BSI | Rg (17), Rg (22) | No | 1.5 g q8h (8)c | No | CVVHDF (3.2) | No | Relapse VAT (11) | Discharged (131) |
Abbreviations: ABSI, Abbreviated Burn Severity Index; APACHE II, Acute Physiology and Chronic Health Evaluation II; BSI, bloodstream infection; CVVHDF, continuous venovenous hemodiafiltration; F, female; FDC, cefiderocol; IHD, intermittent hemodialysis; M, male; MIC, minimum inhibitory concentration; q6h, every 6 hours; q8h, every 8 hours; q12h, every 12 hours; R, resistant; RRT, renal replacement therapy; TBSA, total body surface area; VAP, ventilator-associated pneumonia; VAT, ventilator-associated tracheobronchitis.
MICs from first sample, last sample, and those demonstrating categorical change in interpretation are listed. The total duration of prior cefiderocol exposure at the time of culture collection is in parentheses.
Combination therapy was defined was >48 hours of therapy with confirmed or suspected in vitro activity against the infecting pathogen.
Note that the manufacturer recommendations for dosing in continuous renal replacement therapy were revised during the study period. All patients received dosing consistent with manufacturer recommendations at time of management.
Patient expired prior to completion of therapy.
Steven Johnson syndrome.
ScoreTen scale score (severity of illness score for toxic epidermal necrolysis).
Resistant by Kirby-Bauer disk diffusion testing.