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Cefiderocol: A Siderophore Cephalosporin.
Rania M El-Lababidi1, John George Rizk2
1Cleveland Clinic Abu Dhabi, United Arab Emirates.
The Annals of Pharmacotherapy
|June 12, 2020
Summary
Cefiderocol is a new antibiotic effective against resistant Gram-negative bacteria. However, increased mortality was observed in serious carbapenem-resistant infections, warranting careful consideration and further study.
Area of Science:
- Pharmacology and Infectious Diseases
- Antimicrobial Resistance
- Drug Development
Background:
- Cefiderocol represents a novel siderophore antibiotic approved by the U.S. Food and Drug Administration (FDA).
- It exhibits activity against challenging Gram-negative pathogens, including multidrug-resistant (MDR) strains like *Pseudomonas aeruginosa*, *Acinetobacter baumannii*, Enterobacteriaceae, and *Stenotrophomonas maltophilia*.
- The drug has been investigated for treating complicated urinary tract infections (cUTIs) and nosocomial pneumonia.
Purpose of the Study:
- To review available data on cefiderocol, encompassing its chemistry, spectrum of activity, pharmacokinetics, pharmacodynamics, clinical efficacy, and therapeutic role.
- To synthesize current evidence regarding cefiderocol's use in treating infections caused by resistant Gram-negative bacteria.
Main Methods:
- A comprehensive literature search was performed using PubMed, Google Scholar, and ClinicalTrials.gov from 2009 to March 2020.
- Search terms included 'cefiderocol' and 'S-649266'.
- Data were extracted from published articles, conference abstracts, prescribing information, and regulatory agency websites.
Main Results:
- Cefiderocol demonstrated activity against a broad range of resistant Gram-negative pathogens.
- Clinical studies in adult patients with cUTIs and nosocomial pneumonia indicated good tolerability.
- A recent prospective study noted higher mortality rates associated with cefiderocol in treating serious infections caused by carbapenem-resistant (CR) Gram-negative pathogens.
Conclusions:
- Cefiderocol offers a new therapeutic option for cUTIs and potentially nosocomial pneumonia due to resistant Gram-negative bacteria.
- The observed higher mortality in CR Gram-negative infections necessitates careful consideration of cefiderocol's use in such cases.
- Further phase III clinical studies are required to fully evaluate cefiderocol's role in treating serious infections caused by CR Gram-negative bacteria.
