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cefiderocol (Fetroja)
FDA-approved Nov 2019
Indications:
- multidrug-resistant gram-negative pathogens [2]
- carbapenem-resistant Acinetobacter baumannii infections [4]
- complicated urinary tract infections, including pyelonephritis [1,3]
- ventilator-associated pneumonia [5]
Antimicrobial activity:
- gram-negative pathogen
- carbapenem-resistant Acinetobacter baumannii [4]
- Pseudomonas aeruginosa
- Enterobacteriaceae
- Stenotrophomonas maltophilia
- poor in vitro activity against gram-positive or anaerobic bacteria
Mechanism of action:
- siderophore cephalosporin
- stability against most beta-lactamases including including serine- & metallo- carbapenemases [2]
- able to overcome all 3 major mechanisms of carbapenem resistance
- porin channel alterations
- beta-lactamase inactivation
- efflux pump overproduction
- binds to ferric iron
- actively transported into bacterial cells through the outer membrane via bacterial iron transporters
- can also enter cells by passive diffusion through porin channels
- bind to penicillin-binding proteins
- inhibits cell wall synthesis in the bacterial cells
Interactions
drug adverse effects of cephalosporins
General
cephalosporin
References
- Business Wire. Oct 16, 2019
U.S. FDA Advisory Committee Recommends Approval of Cefiderocol for
Treatment of Complicated Urinary Tract Infections.
https://www.businesswire.com/news/home/20191016005916/en/U.S.-FDA-Advisory-Committee-Recommends-Approval-Cefiderocol
- Dobias J, Denervaud-Tendon V, Poirel L, Nordmann P.
Activity of the novel siderophore cephalosporin cefiderocol against
multidrug-resistant Gram-negative pathogens.
Eur J Clin Microbiol Infect Dis. 2017 Dec;36(12):2319-2327.
PMID: 28748397
https://link.springer.com/article/10.1007%2Fs10096-017-3063-z
- Brooks M
FDA OKs New Antibacterial Cefiderocol (Fetroja) for Complicated UTI.
Medscape. Nov 15, 2019.
https://www.medscape.com/viewarticle/921401
- FDA NEWS RELEASE. Nov 14, 2019
FDA approves new antibacterial drug to treat complicated urinary tract
infections as part of ongoing efforts to address antimicrobial resistance.
https://www.fda.gov/news-events/press-announcements/fda-approves-new-antibacterial-drug-treat-complicated-urinary-tract-infections-part-ongoing-efforts
- Susman E
Novel Siderophore Cephalosporin Nets Promising Results in Tough-to-Treat CRAB.
PROVE offers real-world data in carbapenem-resistant Acinetobacter baumannii.
MedPage Today October 23, 2022
https://www.medpagetoday.com/meetingcoverage/idweek/101369
- Rapid Review Quiz: Hospital-Acquired Pneumonia
Medscape. Sept 15, 2022
https://reference.medscape.com/viewarticle/980567