Cefiderocol

Abstract

Intravenous cefiderocol, commercialized under the name Fetcroja®, is the first siderophore cephalosporin on the market. It was approved by the Haute Autorité de Santé (HAS) for severe infections due to multi-drug resistant Gram-negative bacilli (MDR GNB) when therapeutic options are limited. Indeed, cefiderocol is effective in vitro against the four types of β-lactamases according to the Ambler classification, including metallo-β-lactamases, et shows excellent activity against most GNB, in particular MDR isolates.

In several randomized double-blind trials, cefiderocol showed non-inferiority compared to imipenem/cilastatine in complicated urinary tract infections and to meropenem in health care-associated pneumonia. In a trial on carbapenem-resistant pathogens, cefiderocol demonstrated an activity comparable to the best treatment available, but mortality rate was higher in the cefiderocol arm. Furthermore, cefiderocol seems to be well-tolerated, with only few adverse events found in the randomized trials.

Cefiderocol is a novel molecule effective against MDR GNB, that represents a new therapeutic option in treating complex infections.