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CEFIDEROCOL
Generic Name: CEFIDEROCOL
ABSTRACT -
Cefiderocol (Fetroja) is an FDA-approved novel siderophore cephalosporin with a unique iron-chelating catechol moiety that hijacks bacterial iron-transport systems to deliver the antibiotic across the outer membrane of Gram-negative bacteria. This mechanism enables potent activity against carbapenem-resistant Gram-negative pathogens including Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Stenotrophomonas maltophilia. It inhibits PBP3, disrupting cell wall synthesis.
DOSAGE -
2 g intravenously over 3 hours every 8 hours for 7–14 days in normal renal function; dose and infusion frequency adjusted for renal impairment; extended infusion (3 hours) is required.
SIDE EEFECTS -
- Diarrhoea
- Hypokalaemia
- Elevated liver enzymes
- Constipation
- Infusion site phlebitis
ALLERGIC REACTIONS -
These symptoms may indicate an allergic reaction and require immediate medical attention.
- Cephalosporin/beta-lactam hypersensitivity
- Anaphylaxis
- Urticaria
- Angioedema
DRUG INTERACTIONS-
- Probenecid increases cefiderocol AUC — monitor
- No significant CYP-based interactions
- Nephrotoxic agents: monitor renal function — dose adjustment required based on CrCl
PREAUTONS–
- Renal function must be monitored — dose adjusted for CrCl <60 mL/min
- Beta-lactam allergy history — assess cross-reactivity risk
- Clostridium difficile risk with prolonged broad-spectrum antibiotic use
- Not active against MRSA, Enterococcus, anaerobes
WARNINGS –
- Higher all-cause mortality versus BAT observed in carbapenem-resistant Acinetobacter subgroup in CREDIBLE-CR trial — use with caution in this pathogen
- Reserve for multidrug-resistant Gram-negative infections where alternatives are limited
- Resistance can emerge during treatment — obtain baseline cultures and sensitivities
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