{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T09:11:53Z","timestamp":1764753113514,"version":"3.46.0"},"reference-count":19,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: Cefiderocol (CFD) is a novel cephalosporin targeting multidrug-resistant Gram-negative bacterial (GNB) infections. It mimics siderophores to enter into GNB through iron transport receptors. However, evidence on its use in Hospital at Home (HaH) and outpatient parenteral antibiotic therapy (OPAT) programs remains scarce. Objectives: The primary objective was to evaluate feasibility and efficacy of CFD in HaH setting. The secondary objective was to assess its safety. Methods: A retrospective, observational study was conducted across six Spanish centers between January 2023 and December 2024. Adult patients with documented GNB infections treated with CFD in HaH units were included. Demographic, clinical and microbiological data, treatment characteristics, and outcomes were collected. Statistical analysis was descriptive; no inferential or correlation tests were performed. Results: 27 patients were included; 70.4% were male, with a median age of 69 years. Most infections were nosocomial (65.4%), particularly skin and soft tissue (37%). Septic shock occurred in 14.8% of patients. Pseudomonas aeruginosa (66.7%) and Klebsiella pneumoniae (14.8%) were the most frequent pathogens involved, with Verona Integron-encoded metallo-B-lactamase (VIM, 50%) being the predominant resistance mechanism. CFD was used as a first-line therapy in 63% of cases and in combination with other antibiotics in 40.7%. Median treatment duration was 21.7 days. Administration was mainly via peripherally inserted central catheters (PICC, 33.3%) and electronic pumps (52%). Adverse effects occurred in 7.4% of patients, leading to discontinuation in one case. A total of 88.8% of patients achieved clinical success, with 7.7% recurrence within a month. Escalation of care occurred in 7.7% and 19.2% were readmitted within a month after HaH discharge. No infection-related deaths were reported. Conclusions: CFD is a feasible, safe, and effective treatment for difficult-to-treat GNB infections in HaH settings.<\/jats:p>","DOI":"10.3390\/antibiotics14121216","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T08:44:28Z","timestamp":1764751468000},"page":"1216","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Use of Cefiderocol for Carbapenem-Resistant Gram-Negative Infections in Hospital at Home: Multicentric Real-World Experience"],"prefix":"10.3390","volume":"14","author":[{"given":"Andrea","family":"Parra-Plaza","sequence":"first","affiliation":[{"name":"Hospital at Home Unit, Hospital Cl\u00ednic Barcelona, Universitat de Barcelona, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5801-5000","authenticated-orcid":false,"given":"Ainoa","family":"Ugarte","sequence":"additional","affiliation":[{"name":"Hospital at Home Unit, Hospital Cl\u00ednic Barcelona, Universitat de Barcelona, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9891-1766","authenticated-orcid":false,"given":"Eva","family":"Benavent","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital Universitari de Bellvitge, Hospitalet del Llobregat, 08907 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Garc\u00eda-Pout\u00f3n","sequence":"additional","affiliation":[{"name":"Hospital at Home Unit, Hospital Cl\u00ednic Barcelona, Universitat de Barcelona, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abel","family":"Mujal","sequence":"additional","affiliation":[{"name":"Hospital at Home Unit, Hospital Universitario Parc Taul\u00ed, 08208 Sabadell, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Rosa","family":"Oltra","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Hospital Cl\u00ednic Universitari de Val\u00e8ncia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2874-9289","authenticated-orcid":false,"given":"Andr\u00e9s","family":"Parra-Rojas","sequence":"additional","affiliation":[{"name":"Hospital at Home Unit, Hospital Universitari Vall d\u2019Hebr\u00f3n, 08035 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ver\u00f3nica","family":"Rico","sequence":"additional","affiliation":[{"name":"Hospital at Home Unit, Hospital Cl\u00ednic Barcelona, Universitat de Barcelona, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3477-9625","authenticated-orcid":false,"given":"Manuel","family":"del R\u00edo","sequence":"additional","affiliation":[{"name":"Hospital at Home Unit, Hospital Universitari Son Espases, 07120 Palma, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Nicol\u00e1s","sequence":"additional","affiliation":[{"name":"Hospital at Home Unit, Hospital Cl\u00ednic Barcelona, Universitat de Barcelona, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1128\/AAC.01695-15","article-title":"In Vitro Antimicrobial Activity of a Siderophore Cephalosporin, S-649266, against Enterobacteriaceae Clinical Isolates, Including Carbapenem-Resistant Strains","volume":"60","author":"Kohira","year":"2016","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Diarra, A., Degrendel, M., Eberl, I., Ferry, T., Jaffal, K., Escaut, L., Asquier-Khati, A., Taar, N., Courjon, J., and Deconinck, L. (2025). Real-Life Cefiderocol Use in Bone and Joint Infection: A French National Cohort. Antibiotics, 14.","DOI":"10.3390\/antibiotics14040388"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e00093-17","DOI":"10.1128\/AAC.00093-17","article-title":"In Vitro Activity of the Siderophore Cephalosporin, Cefiderocol, against a Recent Collection of Clinically Relevant Gram-Negative Bacilli from North America and Europe, Including Carbapenem-Nonsusceptible Isolates (SIDERO-WT-2014 Study)","volume":"61","author":"Hackel","year":"2017","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"dlae015","DOI":"10.1093\/jacamr\/dlae015","article-title":"Successful Outpatient Parenteral Antibiotic Therapy with Cefiderocol for Osteomyelitis Caused by Multi-Drug Resistant Gram-Negative Bacteria: A Case Report","volume":"6","author":"Schellong","year":"2024","journal-title":"JAC Antimicrob. Resist."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"ofae631.1645","DOI":"10.1093\/ofid\/ofae631.1645","article-title":"Real-World Effectiveness and Safety of Cefiderocol in the Treatment of Patients with Serious Gram-Negative Bacterial Infections: Results of the PROVE Chart Review Study","volume":"12","author":"Clancy","year":"2025","journal-title":"Open Forum Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/s40121-020-00286-6","article-title":"Cefiderocol: A Novel Agent for the Management of Multidrug-Resistant Gram-Negative Organisms","volume":"9","author":"Wu","year":"2020","journal-title":"Infect. Dis. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Moreal, C., Martini, L., Prataviera, F., Tascini, C., and Giuliano, S. (2025). Antibiotic Stability and Feasibility in Elastomeric Infusion Devices for OPAT: A Review of Current Evidence. J. Clin. Med., 14.","DOI":"10.3390\/jcm14082722"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.eimc.2024.04.001","article-title":"Outpatient Parenteral Antibiotic Therapy (OPAT) through Elastomeric Continuous Infusion Pumps in a Real-Life Observational Study: Characteristics, Safety, and Efficacy Analysis","volume":"42","author":"Giuliano","year":"2024","journal-title":"Enferm. Infecc. Microbiol. Clin."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"165","DOI":"10.22585\/hospdomic.v2i4.53","article-title":"Resumen Ejecutivo del Tratamiento Antibi\u00f3tico Domiciliario Endovenoso: Directrices de la Sociedad Espa\u00f1ola de Enfermedades Infecciosas y la Sociedad Espa\u00f1ola de Hospitalizaci\u00f3n a Domicilio","volume":"2","author":"Aznar","year":"2018","journal-title":"Hosp. Domicilio"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1704","DOI":"10.1093\/jac\/dkx049","article-title":"Activity of Cefiderocol (S-649266) against Carbapenem-Resistant Gram-Negative Bacteria Collected from Inpatients in Greek Hospitals","volume":"72","author":"Falagas","year":"2017","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"102938","DOI":"10.1016\/j.jiph.2025.102938","article-title":"Implementation of Outpatient Parenteral Antimicrobial Therapy Program in the Contemporary Health Care System: A Narrative Review of the Evidence","volume":"18","author":"Mohammed","year":"2025","journal-title":"J. Infect. Public Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e169","DOI":"10.1017\/ash.2023.458","article-title":"Patient Outcomes Following Home-Based Outpatient Parenteral Antimicrobial Therapy and Facility-Based Outpatient Parenteral Antimicrobial Therapy: A Systematic Review and Meta-Analysis","volume":"3","author":"Hasegawa","year":"2023","journal-title":"Antimicrob. Steward. Healthc. Epidemiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"107263","DOI":"10.1016\/j.ijantimicag.2024.107263","article-title":"Safety and Efficacy of Outpatient Parenteral Antimicrobial Therapy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials","volume":"64","author":"Mohammed","year":"2024","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_14","unstructured":"European Medicines Agency (EMA) (2025, October 08). Fetcroja: EPAR\u2014Product Information. Available online: https:\/\/www.ema.europa.eu\/en\/documents\/product-information\/fetcroja-epar-product-information_en.pdf."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Fern\u00e1ndez-Rubio, B., Herrera-Hidalgo, L., de Alarc\u00f3n, A., Luque-M\u00e1rquez, R., L\u00f3pez-Cort\u00e9s, L.E., Luque, S., Guti\u00e9rrez-Urb\u00f3n, J.M., Fern\u00e1ndez-Polo, A., Guti\u00e9rrez-Valencia, A., and Gil-Navarro, M.V. (2023). Stability Studies of Antipseudomonal Beta Lactam Agents for Outpatient Therapy. Pharmaceutics, 15.","DOI":"10.3390\/pharmaceutics15122705"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"dlaf066","DOI":"10.1093\/jacamr\/dlaf066","article-title":"Feasibility of 24 h Continuous-Infusion Cefiderocol Administered by Elastomeric Pump in Attaining an Aggressive PK\/PD Target in the Treatment of NDM-Producing Klebsiella pneumoniae Otomastoiditis","volume":"7","author":"Babich","year":"2025","journal-title":"JAC Antimicrob. Resist."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1093\/jac\/dkae464","article-title":"Optimal dosage regimens of cefiderocol administered by short, prolonged or continuous infusion: A PK\/PD simulation study","volume":"80","author":"Goutelle","year":"2025","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_18","unstructured":"(2025, November 24). ESCMID\u2013European Society of Clinical Microbiology and Infectious Diseases (ESCMID); EUCAST. Available online: https:\/\/www.eucast.org\/."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Tamma, P.D., Heil, E.L., Justo, J.A., Mathers, A.J., Satlin, M.J., and Bonomo, R.A. (2024). Infectious Diseases Society of America 2024 Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections. Clin. Infect. Dis., ciae403.","DOI":"10.1093\/cid\/ciae403"}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/12\/1216\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T09:09:01Z","timestamp":1764752941000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/12\/1216"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,3]]},"references-count":19,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["antibiotics14121216"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics14121216","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,3]]}}}