Integrative Biomedical Research

Integrative Biomedical Research (Journal of Angiotherapy) | Online ISSN  3068-6326
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Awad Mohammed Awad Alanazi 1*, Alanazi, Saqer Owaid A Alotaibi 1, Abdullah Fahad S Alruwaili 1, Mohammed Menwer M Mona 1, Awadallah Aladwani Alshehri 1, Mohammed Alwan J Khaled 1,

+ Author Affiliations

Integrative Biomedical Research 10 (1) 1-8 https://doi.org/10.25163/biomedical.10110917

Submitted: 11 August 2026 Revised: 04 October 2026  Accepted: 13 October 2026  Published: 15 October 2026 


Abstract

Immunocompromised patients—including those with hematological malignancies, transplants, or heavy immunosuppression—face a disproportionate burden of multidrug-resistant organism (MDRO) infections, where therapeutic margins are minimal. This review synthesizes 2020–2026 literature across PubMed, Scopus, and Embase to evaluate contemporary antimicrobial agents and adjunctive non-traditional therapies in pediatric and adult immunocompromised populations. Data on study design, dosing, clinical success, mortality, and resistance emergence were extracted for cefiderocol, ceftazidime/avibactam, eravacycline, temocillin, and phage therapies. Heterogeneous study designs precluded meta-analysis. In the 114-patient adult CEFI-ID cohort, cefiderocol demonstrated a 53.3% day-28 clinical success rate and 37.7% overall mortality. Conversely, a 13-patient pediatric series reported 100% survival using cefiderocol combined with colistin or fosfomycin. Eravacycline efficacy varied markedly by infection site, yielding 80.6% microbiological clearance in intra-abdominal infections versus 32.4% in pulmonary disease. Temocillin proved to be a reliable carbapenem-sparing alternative for lower-severity and urinary tract infections, whereas resistance to carbapenems and third-generation cephalosporins remained high among leukemia and pediatric oncology cohorts. No single novel agent offers universal superiority. Clinical outcomes depend heavily on the specific pathogen resistance mechanism, anatomical infection site, and degree of host immunosuppression. Optimizing care requires prospective trials stratified by these variables, alongside standardized susceptibility testing and robust antimicrobial stewardship strategies.

Keywords: multidrug-resistant organisms; immunocompromised host; cefiderocol; antimicrobial stewardship; carbapenem resistance; bloodstream infection; novel antibiotics

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