Title: Current cLinical scEnARios for the use of cefidErocol in multidrug-Resistant infections: a case study-based approach

Background: The CLEARER project is a study aiming to investigate the use of Cefiderocol, a novel siderophore-cephalosporin conjugate antibiotic approved for treatment of gram-negative bacterial (GNB) infections. Current options for carbapenem-resistant (CR) pathogens are limited, and mortality rates for multidrug resistant (MDR)-Gram-negative bacteria (GNB) remain high. Although there is an increasing number of studies analysing cefiderocol efficacy in vivo and in vitro, human studies remain scarce. 

This project aims to write a final report including the current orientation that clinicians have in the use of cefiderocol for the treatment of MDR-GNB infections. 

Clinical topics: 

1. Availability of carbapenemase production detection and antimicrobial susceptibility testing of novel agents such as cefiderocol 

2. Type of infections addressed (e.g., sepsis, pneumonia) 

3. Target pathogens and their related resistance mechanisms 

4. Clinical setting and patients’ comorbidities 

5. Clinical use: 5.1 As empiric or targeted treatment (e.g., why do clinicians use or switch to cefiderocol); 5.2 Use of cefiderocol as monotherapy or in association with other antibiotics; 5.3 Dosing and variations from label dosing. 

Output: The CLEARER study will inform on the off-label use of cefiderocol, on its use as monotherapy or combination therapy, and on the risks of development of antimicrobial resistance to novel antibiotics.