677. Systematic Review of the Early Use Experince of Cefiderocol in Real World Practice

Abstract Background Gram-negative bacteria (GNB) with resistance to carbapenems is a growing global public health concern. The World Health Organisation have listed three priority GNB pathogens for the development of novel antimicrobial agents; Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacterales. purpose this systematic review (SR) was report evidence on use cefiderocol (FDC), siderophore cephalosporin, patients infections in compassionate or expanded access settings. Methods Searches were undertaken identify relevant up December 2021. Two independent reviewers screened records retrieved relevance SR disagreements adjudicated by third reviewer. Patients receiving FDC use, setting those limited treatment options infection eligible. Eligible case reports series assessed quality using predefined tools data extracted (by single reviewer checking performed second reviewer), tabulated summarised. Results Forty-four studies (n=150 patients) identified reporting FDC; 3 41 reports. most commonly reported P. (41.3%), A. baumannii (36.0%) xylosoxidans (14.3%). diagnoses varied widely across included patients. All administered at dose between 750 mg 2 g per day various schedules, adjusted renal function one six weeks. Clinical cure 137 author-specified definitions 74 (54.0%) clinical 18 (13.1%) failure. Microbiological eradication 78 whom 56 (71.8%) success, while 22 (28.2%) For mortality (n=123) 80 (65.0%) remained alive end treatment, 43 (35.0%) died. Adverse event (AE) 53 13 (24.5%) AEs, 40 (75.5%) did not. See Table 1.0. Conclusion promising therapy options. Real world practice shows high microbiological rate small number AEs. Disclosures Carlo Tascini, n/a, Shionogi: Grant/Research Support Aurelien Dinh, Professor Infectious Disease, Advisor/Consultant|Shionogi: Board Member Christopher M. Longshaw, PhD, Employee Anita C. Fitzgerald, MPH, Shionogi commissioned York Economics Consortium which I am an associate, conduct we are submitting IDWeek Hannah Wood, BA MA, employee, Jacoby Vivien Patterson, MA Cantab, MB BChir, FFPH MD, IDW Deborah Watkins, MSc, Katy Wilson, LLM, employee Karan Gill, Master Science, Employee.