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XDR Acinetobacter — SCE Infectious Diseases MCQ

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HardAntimicrobial StewardshipXDR AcinetobacterSCE Infectious Diseases

A ventilated patient has XDR A. baumannii pneumonia. The isolate is susceptible to cefiderocol and resistant to all routinely suitable alternatives; renal function is normal. Which statement best reflects current NICE advice?

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Correct answer: DStart cefiderocol after specialist review

NICE recommends cefiderocol within its marketing authorisation for severe susceptible drug-resistant Gram-negative infection only when other suitable treatments are unavailable, with microbiology or infectious-disease specialist advice. Its SmPC includes HAP/VAP experience but warns of increased mortality observed in critically ill carbapenem-resistant infections, particularly Acinetobacter, so this is a restricted specialist decision rather than routine preference.

Reference: NICE AMR2: https://www.nice.org.uk/guidance/AMR2/chapter/1-recommendations; cefiderocol SmPC: https://www.medicines.org.uk/emc/product/11771/smpc