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Cefiderocol: A Novel Agent for the Management of Multidrug-Resistant Gram-Negative Organisms
Open accessAbstract
Cefiderocol, formerly S-649266, is a first in its class, an injectable siderophore cephalosporin that combines a catechol-type siderophore and cephalosporin core with side chains similar to cefepime and ceftazidime. This structure and its unique mechanism of action confer enhanced stability against hydrolysis by many β-lactamases, including extended spectrum β-lactamases such as CTX-M, and carbapenemases such as KPC, NDM, VIM, IMP, OXA-23, OXA-48-like, OXA-51-like and OXA-58. Cefiderocol's spectrum of activity encompasses both lactose-fermenting and non-fermenting Gram-negative pathogens, including carbapenem-resistant Enterobacterales. Cefiderocol recently received US Food and Drug Administration approval for the treatment of complicated urinary tract infections, including pyelonephritis, and is currently being evaluated in phase III trials for nosocomial pneumonia and infections caused by carbapenem-resistant Gram-negative pathogens. The purpose of this article is to review existing data on the mechanism of action, microbiology, pharmacokinetics, pharmacodynamics, efficacy, and safety of cefiderocol to assist clinicians in determining its place in therapy.
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“Apart from binding their primary ligand, FeEnt, with high affinity, and its aposiderophore Ent with 100-200-fold lower affinity (38), KpnFepA_1658, KpnIroN, and KpnFepA_4984 showed different preferences for ferric catecholate complexes and siderophore antibiotics cefiderocol [FeFDC (40,41)] and FeMB-1 (42,43):”
From Siderophore-mediated iron acquisition by Klebsiella pneumoniae (2024) · cites this paper as [41]
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Metadata
- Authors
- Wu, J. Y., Srinivas, P., & Pogue, J. M.
- Affiliations
- Cleveland Clinic (US)
- University of Michigan (US)
- Corresponding author
- Wu, Janet Y.
- Venue
- Infectious Diseases and Therapy
- Published
- 2020-02-18
- Volume
- 9
- Issue
- 1
- Pages
- 17-40
- ISSN
- 2193-6382 (ISSN-L)
- 2193-8229
- PMC
- PMC7054475
- OpenAlex
- W3008901682
- Cited by
- 195
- References
- 45
- Citations by year
- 2026: 25 · 2025: 25 · 2024: 25 · 2023: 37 · 2022: 36 · 2021: 28 · 2020: 18
- FWCI
- 2.10
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Infectious Diseases and Therapy (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
- Health Sciences › Medicine › Pharmacology (medical) › Antibiotics Pharmacokinetics and Efficacy
- Health Sciences › Medicine › Urology › Urinary Tract Infections Management
- Keywords
- cefiderocol, siderophore cephalosporin, multidrug-resistant Gram-negative bacteria, carbapenem resistance, extended-spectrum beta-lactamase, carbapenemase, mechanism of action, pharmacokinetics, pharmacodynamics, complicated urinary tract infection, nosocomial pneumonia, Enterobacterales, drug safety and efficacy
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