An Assessment Of Cefiderocol's Synergistic Effects With Eravacycline, Colistin, Meropenem, Levofloxacin, Ceftazidime/avibactam, And Tobramycin Against Carbapenem-Resistant and -Susceptible Pseudomonas aeruginosa
Abstract
OBJECTIVES
This research examines the combined in vitro effectiveness of cefiderocol with other antibiotics against carbapenem-resistant and -susceptible Pseudomonas aeruginosa obtained from Intensive Care Units.
METHODS
Forty unique P. aeruginosa isolates were evaluated for their minimum inhibitory concentrations (MICs) using broth microdilution. All the isolates were evaluated for carbapenemase resistance genes. The bactericidal and synergistic effects of cefiderocol, alone or in conjunction with other antimicrobials, were assessed using time-kill curve experiments.
RESULTS
Colistin had the lowest MIC50/MIC90 value of 1/2 mg/L, with cefiderocol following at 0.5/4 mg/L against the tested strains. Cefiderocol, levofloxacin, tobramycin, and meropenem showed bactericidal activity against various isolates. In carbapemase-producing P. aeruginosa strains, almost half of them were carrying blaVIM. Moreover, the most effective synergistic interactions were seen with combinations of cefiderocol and eravacycline, cefiderocol and meropenem, and cefiderocol and levofloxacin against four out of eight strains at 1xMIC concentrations after 24 h. Additionally, we observed synergistic effects when cefiderocol was used with colistin, tobramycin, and ceftazidime/avibactam against three of the eight isolates. Antagonism against the analyzed P. aeruginosa strains was not found.
CONCLUSION
The findings of this study indicate that combining cefiderocol enhances its synergistic efficacy against…
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