Case Commentary: the Need for Cefiderocol Is Clear, but Are the Supporting Clinical Data?

Antimicrob Agents Chemother. 2020 Mar 24;64(4):e00059-20. doi: 10.1128/AAC.00059-20. Print 2020 Mar 24.

Abstract

Cefiderocol is a newly approved siderophore cephalosporin that demonstrates expanded in vitro activity against multidrug-resistant Gram-negative bacteria. In two challenging cases reported here, cefiderocol shows potential utility as salvage therapy against difficult-to-treat pathogens with limited or no treatment options; however, two multicenter, randomized clinical trials have yielded mixed results among cefiderocol-treated patients. Taken together, clinicians must balance a clear need for cefiderocol in clinical practice with the uncertainties that have stemmed from the available data.

Keywords: CRE; cefiderocol; multidrug resistance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / therapeutic use*
  • Azabicyclo Compounds / therapeutic use
  • Bacteremia / drug therapy
  • Bacteremia / microbiology
  • Cefiderocol
  • Ceftazidime / therapeutic use
  • Cephalosporins / therapeutic use*
  • Drug Combinations
  • Drug Resistance, Multiple, Bacterial / physiology
  • Humans
  • Klebsiella Infections / drug therapy*
  • Klebsiella pneumoniae / drug effects*
  • Male
  • Microbial Sensitivity Tests
  • Osteomyelitis / drug therapy
  • Osteomyelitis / microbiology
  • Polymyxin B / therapeutic use
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas aeruginosa / drug effects*
  • Siderophores / therapeutic use
  • beta-Lactamases / metabolism

Substances

  • Anti-Bacterial Agents
  • Azabicyclo Compounds
  • Cephalosporins
  • Drug Combinations
  • Siderophores
  • avibactam, ceftazidime drug combination
  • Ceftazidime
  • beta-Lactamases
  • Polymyxin B