SynthesisInfection2025
Are cefiderocol or sulbactam/durlobactam better than alternative best available treatment for infection by carbapenem-resistant A. baumannii? A systematic literature review.
Synthesis in Infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Global and regional prevalence of metallo-β-lactamases in carbapenem-resistant Acinetobacter baumannii: a systematic review and meta-analysis.The Journal of antimicrobial chemotherapy · 2026Pooled it
- Interpretive agreement of susceptibility between broth microdilution and disk diffusion methods for cefiderocol, using criteria from the Clinical and Laboratory Standards Institute, European Committee on Antimicrobial Susceptibility Testing, and the Food and Drug Administration.Journal of clinical microbiology · 2026Article
- Recent Advances and Future Perspectives in the Detection of Carbapenem-ResistantInfection and drug resistance · 2026Review
- Innovative Antibiotics: The Experience of Cefiderocol in Carbapenem-Resistant Gram-Negative Infections.Infection and drug resistance · 2026Review
- The Therapeutic Potential of Cefiderocol in the Treatment of Multidrug-Resistant Gram-Negative Bacteria: A Narrative Review.Journal of clinical medicine · 2025Review
- Cefiderocol: A Comprehensive Review of Chemistry, Mechanisms of Resistance, and Clinical Applications in the Era of Multidrug Resistance.Current microbiology · 2025Review
- Does Early Concordant Antibiotic Treatment Reduce Mortality Among Hospitalized Patients with Carbapenem-ResistantJournal of clinical medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCefiderocol (CFDC) and sulbactam/durlobactam (SUL/DUR) are new treatment options against infections by carbapenem-resistant A. baumannii (CRAB). However, whether they outperform contemporary alternative best available therapy (BAT), currently consisting of high-dose ampicillin/sulbactam (AMP/SUL)-based regimens, is unclear.
methodsA systematic review was conducted in PubMed and clinical trial registries to assess regimens used in comparator arms in studies comparing CFDC or SUL/DUR to alternative treatment regimens.
resultsOnly 1 relevant study was found for SUL/DUR (the registrational Phase 3). Almost all (98%) patients enrolled had pneumonia and the comparator arm was colistin/imipenem, a regimen not recommended for treatment of CRAB infections, especially pneumonia. With regards to CFDC, subgroup analyses (with significant limitations) from 2 randomized trials were disappointing showing higher mortality in CREDIBLE-CR compared to colistin-based treatment and similar mortality in APEKS-NK compared to high-dose meropenem among patients with CRAB infections. The rest (n = 11) of the trials were observational, predominantly single-center (82%) and retrospective (82%), and all but one were conducted in Italy (91%). Although meta-analyses of observational studies suggest better outcomes with CFDC, the comparator arm was colistin-based in all cases and only a minority of patients had received high-dose AMP/SUL.
conclusionHigh-quality evidence supporting use of either CFDC or SUL/DUR in favor of high-dose AMP/SUL-based regimens is lacking. This has important stewardship implications. Additionally, both CFDC and SUL/DUR are much more expensive than AMP/SUL, an important consideration especially for low-/mid-income countries. Studies comparing CFDC- and SUL/DUR-based treatments to contemporary alternative BAT are needed.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.