TABLE 2.
In vitro activity of cefiderocol, BLBLI combinations, and other relevant antibiotics against P. aeruginosa and Acinetobacter spp. isolates with resistant phenotypesa,b
| Isolates | n | Susceptibilityc (%) | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| FDC | MEM | CZA | C-T | MVB | I-R | ATM-AVI | FEP-TAN | SUL-DUR | (CST) | ||
| P. aeruginosa | 950 | 98.9 | 85.4 | 90.1 | 89.1 | 87.2 | 83.3 | 86.2 | 91.4 | N/A | (99.7) |
| MEM-R | 139 | 97.8 | 56.8 | 55.4 | 12.2 | 12.2 | 41.7 | 59.7 | N/A | (100) | |
| CZA-R | 94 | 93.6 | 36.2 | 36.2 | 39.4 | 37.2 | 54.3 | 55.3 | N/A | (100) | |
| C-T-R | 104 | 94.2 | 40.4 | 42.3 | 45.2 | 36.5 | 64.4 | 59.6 | N/A | (100) | |
| MVB-R | 122 | 97.5 | 0 | 53.3 | 53.3 | 10.7 | 38.5 | 59.0 | N/A | (100) | |
| I-R-R | 159 | 98.1 | 23.3 | 62.9 | 58.5 | 31.4 | 54.1 | 64.8 | N/A | (100) | |
| ATM-AVI-R | 131 | 95.4 | 38.2 | 67.2 | 71.8 | 42.7 | 44.3 | 61.8 | N/A | (100) | |
| FEP-TAN-R | 82 | 95.1 | 31.7 | 48.8 | 48.8 | 39.0 | 31.7 | 39.0 | N/A | (100) | |
| MEM-R and CZA-R | 60 | 96.7 | 28.3 | 5.0 | 8.3 | 45.0 | 43.3 | N/A | (100) | ||
| MEM-R and C-T-R | 62 | 98.4 | 30.6 | 8.1 | 9.7 | 54.8 | 50.0 | N/A | (100) | ||
| Acinetobacter spp. | 501d | 92.4 | 54.7 | N/A | N/A | N/A | N/A | N/A | N/A | 97.0 | (98.4) |
| FDC-R | 38 | 10.5 | N/A | N/A | N/A | N/A | N/A | N/A | 65.8 | (92.1) | |
| MEM-R | 227 | 85.0 | N/A | N/A | N/A | N/A | N/A | N/A | 93.8 | (97.4) | |
| SUL-DUR-Re | 15 | 13.3 | 6.7 | N/A | N/A | N/A | N/A | N/A | N/A | (100) | |
ATM-AVI, aztreonam-avibactam; BLBLI, β-lactam/β-lactamase inhibitor; CST, colistin; C-T, ceftolozane-tazobactam; CZA, ceftazidime-avibactam; ECOFF, epidemiological cut-off; EUCAST, European Committee on Antimicrobial Susceptibility Testing; FDA, Food and Drug Administration; FDC, cefiderocol; FEP-TAN, cefepime-taniborbactam; I-R, imipenem-relebactam; MEM, meropenem; MVB, meropenem-vaborbactam; N/A, not applicable; PD, T, ceftolozane-tazobactam; CZA, ceftazidime-avibactam; ECOFF, epidemiological cut-off; EUCAST, European Committee on Antimicrobial Susceptibility Testing; FDA, Food and Drug Administration; FDC, cefiderocol; FEP-TAN, cefepime-taniborbactam; I-R, imipenem-relebactam; MEM, meropenem; MVB, meropenem-vaborbactam; N/A, not applicable; PD, pharmacodynamic; PK, pharmacokinetic; R, resistant; SUL-DUR, sulbactam-durlobactam.
Antimicrobials were tested against P. aeruginosa and/or Acinetobacter spp. based on expected use in a real-world setting. Results are not reported for isolates tested against antibiotics to which they had an expected resistance phenotype. Susceptibility was assessed according to EUCAST breakpoints (including non-species-specific PK/PD breakpoints, high dosage breakpoints, and breakpoints for the agent without inhibitor, where applicable), except for sulbactam-durlobactam and colistin where FDA breakpoints and ECOFF values were used, respectively. Data are shown where n ≥ 20 isolates were available. Data on susceptibility to colistin are shown in parentheses as colistin is not recommended for monotherapy and is not associated with a clinical monotherapy breakpoint (as per EUCAST v.14.0 guidance).
Refers to susceptibility, or susceptibility with increased exposure for meropenem, meropenem-vaborbactam, aztreonam-avibactam, and cefepime-taniborbactam.
Includes 458 A. baumannii complex isolates.
Sulbactam-durlobactam-resistant isolates were included irrespective of the number of isolates due to the scarcity of published data.