{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T19:56:45Z","timestamp":1793303805122,"version":"4.5.0"},"reference-count":28,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"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\/Objectives: Infections caused by multidrug-resistant Gram-negative bacteria (MDR-GNB) represent a major therapeutic challenge, particularly in hospitalized and critically ill patients with limited treatment options. Cefiderocol, a novel siderophore cephalosporin, has demonstrated activity against a broad range of resistant Gram-negative pathogens. We aimed to evaluate the effectiveness and safety of cefiderocol for the treatment of MDR-GNB infection. Methods: We conducted a retrospective observational study including all adult patients who received \u226572 h of cefiderocol between November 2020 and October 2024 at a Spanish tertiary-care hospital. The primary outcome was clinical success, defined as survival and absence of clinical recurrence 30 days after cefiderocol initiation. Secondary outcomes included 30- and 90-day mortality, clinical and microbiological recurrence, emergence of resistance, and adverse events. Results: Eighty patients were included (median age 64 years [IQR 56\u201372]; 81.3% male). Respiratory (26.2%) and abdominal (22.5%) infections were the most common, and 20% presented with bacteremia. At infection onset, 26.2% had septic shock and 45% required intensive care unit admission. The three most frequently isolated pathogen was Pseudomonas aeruginosa (33.9%), followed by Enterobacterales (33%) and Stenotrophomonas maltophilia (30.1%). Clinical success was achieved in 67.5% of patients. Thirty and 90-day mortality rates were 27.5% and 36.5%, respectively. Recurrence within 90 days occurred in 5% of cases. Emergence of resistance was detected in one Klebsiella pneumoniae ST147 isolate, and serious adverse events occurred in 5% of patients. Conclusions: In a cohort including a substantial proportion of critically ill patients, cefiderocol was associated with favorable clinical outcomes and an acceptable safety profile. These findings suggest that cefiderocol may represent a useful therapeutic option for severe MDR-GNB infections in patients with limited treatment alternatives.<\/jats:p>","DOI":"10.3390\/antibiotics15040416","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T12:01:22Z","timestamp":1776686482000},"page":"416","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cefiderocol Targeted Treatment for Multidrug-Resistant Gram-Negative Infections: An Observational Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Lourdes","family":"Garc\u00eda-Carnero","sequence":"first","affiliation":[{"name":"Infectious Diseases Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8158-9934","authenticated-orcid":false,"given":"Gabriela","family":"Abelenda-Alonso","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Bellvitge Biomedical Research Institute (IDIBELL), 08908 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Research Network for Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Santos-Puig","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariadna","family":"Padull\u00e9s","sequence":"additional","affiliation":[{"name":"Bellvitge Biomedical Research Institute (IDIBELL), 08908 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Research Network for Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Pharmacy Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1948-5183","authenticated-orcid":false,"given":"Clara","family":"Ribera","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Lamiel","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Costa-Primo","sequence":"additional","affiliation":[{"name":"Microbiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel Gonz\u00e1lez de","family":"Aledo","sequence":"additional","affiliation":[{"name":"Microbiology Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Granada","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4010-2994","authenticated-orcid":false,"given":"V\u00edctor Daniel","family":"Gumucio","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Santafosta","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Gilabert","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Blanco-Ar\u00e9valo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Bellvitge Biomedical Research Institute (IDIBELL), 08908 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Research Network for Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0722-2218","authenticated-orcid":false,"given":"Mireia","family":"Puig-Asensio","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Bellvitge Biomedical Research Institute (IDIBELL), 08908 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Research Network for Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1882-1259","authenticated-orcid":false,"given":"Evelyn","family":"Shaw","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Bellvitge Biomedical Research Institute (IDIBELL), 08908 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Research Network for Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3209-2563","authenticated-orcid":false,"given":"Jordi","family":"Carratal\u00e0","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Bellvitge Biomedical Research Institute (IDIBELL), 08908 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Research Network for Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3095-4422","authenticated-orcid":false,"given":"Carlota","family":"Gudiol","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Bellvitge University Hospital, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Bellvitge Biomedical Research Institute (IDIBELL), 08908 L\u2019Hospitalet de Llobregat, Spain"},{"name":"Research Network for Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"Institut Catal\u00e0 d\u2019Oncologia (ICO), Hospital Duran i Reynals, 08908 L\u2019Hospitalet de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/S0140-6736(24)02081-6","article-title":"Multidrug-resistant Gram-negative bacterial infections","volume":"405","author":"Macesic","year":"2025","journal-title":"Lancet"},{"key":"ref_2","unstructured":"World Health Organization, and European Centre for Disease Prevention and Control (2022). 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