Real-World Experience of Imipenem-Relebactam Treatment as Salvage Therapy in Difficult-to-Treat Pseudomonas aeruginosa Infections (IMRECOR Study)

Abstract

Introduction: Difficult-to-treat-resistant (DTR) infections caused by Pseudomonas aeruginosa represent a global public health threat, prioritizing the search and development of new antibiotics for this microorganism.

Methods: We present the real-life experience of the compassionate use of imipenem/cilastatin/relebactam in a descriptive study involving 14 patients with DTR-P. aeruginosa infection and limited treatment options.

Results: The primary source of infection was skin and soft tissue infection, 57.1% (8/14), followed by respiratory infection-pneumonia, 28.6% (4/14). At the onset of infection, 71.4% (10/14) of patients were in the intensive care unit (ICU). All our patients had a Charlson Score of ≥ 3. Septic shock was observed in 64.3% (9/14) of patients. The median treatment duration was 15 days, and no patient experienced an adverse event that required treatment interruption. All-cause 30-day mortality was observed in 42.9% of cases (6/14), while clinical efficacy and microbiological success were observed in 64.3% (9/14).

Conclusions: Imipenem/cilastatin/relebactam may represent a treatment option for patients with DTR-P. aeruginosa infections, which should be validated in prospective clinical trials.

Keywords: Pseudomonas aeruginosa; Carbapenem; Cilastatin; Imipenem; Multidrug; Relebactam; Resistant.