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Cefiderocol: A Review in Serious Gram-Negative Bacterial Infections
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Journal Article
Cefiderocol: A Review in Serious Gram-Negative Bacterial Infections
2021
Overview
Intravenous cefiderocol (Fetroja
®
; Fetcroja
®
) is the first siderophore cephalosporin approved for the treatment of adults with serious Gram-negative bacterial infections. Cefiderocol is stable against all four Ambler classes of β-lactamases (including metallo-β-lactamases) and exhibits excellent in vitro activity against many clinically relevant Gram-negative pathogens, including multidrug resistant strains. In randomized, double-blind clinical trials, cefiderocol was noninferior to imipenem/cilastatin for the treatment of complicated urinary tract infections (cUTI) and to meropenem for nosocomial pneumonia. Furthermore, in a pathogen-focused clinical trial in patients with carbapenem-resistant (CR) infections, cefiderocol showed comparable efficacy to best available therapy (BAT), albeit all-cause mortality rate was higher in the cefiderocol arm, the cause of which has not been established. Cefiderocol had a good tolerability and safety profile in clinical trials. Thus cefiderocol is a novel, emerging, useful addition to the current treatment options for adults with susceptible Gram-negative bacterial infections (including cUTI and nosocomial pneumonia) for whom there are limited treatment options.
Plain Language Summary
Infections caused by carbapenem-resistant (CR) Enterobacterales and nonfermenters (such as
Pseudomonas
,
Acinetobacter
,
Stenotrophomonas
,
Burkholderia
) are a major global health threat. Cefiderocol, a cephalosporin with activity against CR Enterobacterales and nonfermenters, uses the bacteria’s own iron uptake system to gain cell entry, like a Trojan horse. Once inside, the drug disrupts the formation of the bacterial cell wall, killing the bacteria. Cefiderocol is approved for the treatment of serious Gram-negative bacterial infections. In clinical trials, cefiderocol was effective versus carbapenems or best available therapy for complicated urinary tract infections, nosocomial pneumonia and bloodstream infections/sepsis, including those caused by CR bacteria. The drug had a good tolerability and safety profile. Thus, cefiderocol is a useful addition to the current treatment options for adults with cefiderocol-susceptible Gram-negative bacterial infections for whom there are limited treatment options.
Publisher
Springer International Publishing,Springer Nature B.V
Subject
/ Adults
/ Anti-Bacterial Agents - pharmacokinetics
/ Anti-Bacterial Agents - pharmacology
/ Anti-Bacterial Agents - therapeutic use
/ Bacteria
/ Cephalosporins - pharmacokinetics
/ Cephalosporins - pharmacology
/ Cephalosporins - therapeutic use
/ Chromium
/ Drug Resistance, Bacterial - physiology
/ Gram-Negative Bacterial Infections - drug therapy
/ Healthcare-Associated Pneumonia - drug therapy
/ Humans
/ Imipenem
/ Medicine
/ Randomized Controlled Trials as Topic
/ Sepsis
