- •Cefiderocol is the first intravenous siderophore cephalosporin antimicrobial that was approved by the FDA.
- •Cefiderocol's innovative mechanism of action retains activity against highly resistant aerobic gram-negative microorganisms which threaten clinical practice.
- •Cefiderocol is indicated in susceptible gram-negative infections attributed to complicated urinary tract infection cUTI including pyelonephritis, hospital acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP).
- •Cefiderocol's utility requires judicious considerations in the presence of antimicrobial resistance to maximize benefit clinically while minimizing the development of future antimicrobial resistance.
Global concern regarding antimicrobial resistance has allowed for innovative antimicrobials to emerge specifically in the presence of infections caused by resistant gram-negative microorganisms. The outer membrane of gram-negative microorganisms can hinder antimicrobial penetration. A novel approach to infiltrate gram-negative microorganisms would be to use their own transport systems. Cefiderocol is the first approved intravenous siderophore cephalosporin to treat resistant gram-negative infections. Cefiderocol achieves direct entry into the bacteria’s periplasmic space, avoiding mechanisms of resistance encountered with antimicrobials in clinical practice. Cefiderocol can revolutionize clinical practice with its original mechanism of action and sustainable activity against resistant gram-negative microorganisms.
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- Antibiotic Resistance Threats in the United States.https://www.cdc.gov/drugresistance/pdf/threats-report/2019-ar-threats-report-508.pdfDate: 2019Date accessed: August 12, 2022
- New report calls for urgent action to avert antimicrobial resistance crisis.(29 April 2019)https://www.who.int/news/item/29-04-2019-new-report-calls-for-urgent-action-to-avert-antimicrobial-resistance-crisisDate accessed: August 12, 2022
- ([package insert])Fetroja®. Shionogi % Co., Ltd., Osaka, Japan2020
- Cefiderocol versus high-dose, extended-infusion meropenem for the treatment of Gram- nosocomial pneumonia (APEKS-NP): a randomised, double-blind, phase 3, non-inferiority trial.Lancet Infect Dis. 2021; 21: 213-225https://doi.org/10.1016/S1473-3099(20)30731-3
- Cefiderocol, a siderophore cephalosporin for gram-negative bacterial infections: pharmacokinetics and safety in subjects with renal impairment.J Clin Pharmacol. 2017; 57: 584-591https://doi.org/10.1002/jcph.841
- Efficacy and safety of cefiderocol or best available therapy for the treatment of serious infections caused by carbapenem-resistant Gram-negative bacteria (CREDIBLE-CR): a randomised, open-label, multicentre, pathogen-focused, descriptive, phase 3 trial.Lancet Infect Dis. 2020; 21: 226-240https://doi.org/10.1016/S1473-3099(20)30796-9
- Cefiderocol versus imipenem-cilastatin for the treatment of complicated urinary tract infections caused by gram-negative uropathogens: a phase 2, randomised, double-blind, non-inferiority trial.Lancet Infect Dis. 2018; 18: 1319-1328https://doi.org/10.1016/S1473-3099(18)30554-1
- In vitro antibacterial properties of cefiderocol, a novel siderophore cephalosporin, against Gram-negative bacteria.Antimicrob Agents Chemother. 2017; 62 (e01454-17)https://doi.org/10.1128/AAC.01454-17
- The role of iron and siderophores in infection, and the development of siderophore antibiotics.Clin Infect Dis. 2019; 69: S529-S537https://doi.org/10.1093/cid/ciz825
Cefiderocol. Lexi-Drugs. Lexicomp. Wolters Kluwer Health, Inc. Riverwoods, IL. Accessed August 5, 2022. http://online.lexi.com
- In vitro activity of cefiderocol against a broad range of clinically important gram-negative bacteria.Clin Infect Dis. 2019 2019; 69: S544-S551https://doi.org/10.1093/cid/ciz827
- New perspectives on antimicrobial agents: cefiderocol.Antimicrob Agents Chemother. 2021; 65e0217120https://doi.org/10.1128/AAC.02171-20
- Evolution of cefiderocol non-susceptibility in Pseudomonas aeruginosa in a patient without previous exposure to the antibiotic.Clin Infect Dis. 2021; 73: e4472-e4474https://doi.org/10.1093/cid/ciaa1909
- Case commentary: the need for cefiderocol is clear, but are the supporting clinical data?.Antimicrob Agents Chemother. 2020; 64: e00059-20https://doi.org/10.1128/AAC.00059-20
- Pharmacokinetic and pharmacodynamic profiles of cefiderocol, a novel siderophore cephalosporin.Clin Infect Dis. 2019; 69: S552-S558https://doi.org/10.1093/cid/ciz828
- Pharmacokinetics, safety, and tolerability of cefiderocol, a novel siderophore cephalosporin for gram-negative bacteria, in healthy subjects.Antimicrob Agents Chemother. 2018; 62 (e02163-17)https://doi.org/10.1128/AAC.02163-17
Nino Marzella, PharmD, BCPS, is an Associate Professor of Pharmacy Practice, Long Island University Pharmacy, Arnold and Marie Schwartz College of Pharmacy, and Clinical Pharmacy Specialist, New York Harbor Healthcare System, Department of Veterans Affairs, Brooklyn Campus, Brooklyn, and can be contacted at [email protected]
Published online: February 07, 2023
In compliance with standard ethical guidelines, the author reports no relationships with business or industry that would pose a conflict of interest.
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