In vitro pharmacokinetics of cefiderocol alone and in combination with antibiotics against Achromobacter spp. and Stenotrophomonas maltophilia species
Abstract
The point of this study was to compare and to contrast how well cefiderocol worked against a group of Achromobacter spp. and Stenotrophomonas maltophilia isolates in-vitro, both by itself and when mixed with other antibiotics. Cefiderocol, a new antibiotic, is highly effective against S. maltophilia and multidrug-resistant Gram-negative bacteria, including carbapenem-resistant Enterobacterales, Pseudomonas aeruginosa , and Acinetobacter baumannii . The U.S. Food and Drug Administration (FDA) approved it for treating nosocomial pneumonia (e.g., ventilator-associated pneumonia) and complicated urinary tract infections caused by susceptible aerobic Gram-negative bacteria. However, evidence is insufficient regarding cefiderocol combination therapy for Achromobacter spp. and S. maltophilia . We determined the MICs of cefiderocol and the tested antibiotics for 40 isolates total of S. maltophilia and Achromobacter spp. We then tested various cefiderocol MICs in time-kill experiments, using cefiderocol alone and in combination with comparators. Cefiderocol was the agent with the highest susceptibility rate (100%). Cefiderocol also displayed the lowest MIC50 and MIC90 values. We observed synergy in time-kill experiments when we combined cefiderocol with levofloxacin or colistin at 1xMIC concentration. These data suggest that cefiderocol displays potent in vitro activity against S. maltophilia and Achromobacter spp. Our research shows that cefiderocol, levofloxacin, and colistin work…
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