Cefiderocol

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Cefiderocol Brand Name– FETROJA

What is Cefiderocol

Cefiderocol is a parenteral siderophore cephalosporin antibacterial indicated for the treatment of complicated urinary tract infections (cUTIs), including pyelonephritis, in adults who have limited or no treatment options.

Approval of cefiderocol for this indication is based on limited clinical safety and efficacy data. In a multinational, randomized, open-label trial in critically-ill patients with carbapenem-resistant gram-negative bacterial infections, an increase in all-cause mortality was observed in patients receiving cefiderocol compared to those receiving best available therapy.

Patients with nosocomial pneumonia, bloodstream infections, sepsis, or cUTIs were included in the trial. The increase in all-cause mortality occurred in patients treated for nosocomial pneumonia, bloodstream infections, or sepsis.

Generally, death occurred in patients with infections caused by gram-negative organisms and was the result of worsening or complications of infection or underlying comorbidities.

The cause of the increase in mortality has not been established. Safety and efficacy of cefiderocol has not been established for the treatment of nosocomial pneumonia, bloodstream infections, or sepsis.

Cefiderocol functions as a siderophore and binds to extracellular free ferric iron. In addition to passive diffusion via porin channels, cefiderocol is actively transported across the outer cell membrane of bacteria into the periplasmic space using a siderophore iron uptake mechanism.

Indications

  1. Acinetobacter baumannii
  2. Citrobacter freundii
  3. Citrobacter koseri
  4. Enterobacter cloacae
  5. Escherichia coli
  6. Klebsiella aerogenes
  7. Klebsiella oxytoca
  8. Klebsiella pneumoniae
  9. Morganella morganii
  10. Proteus mirabilis
  11. Proteus vulgaris
  12. Providencia rettgeri
  13. Pseudomonas aeruginosa
  14. pyelonephritis
  15. Serratia marcescens
  16. Stenotrophomonas maltophilia
  17. urinary tract infection (UTI)

Side Effects

  1. abdominal pain
  2. anaphylactoid reactions
  3. anorexia
  4. asterixis
  5. atrial fibrillation
  6. bradycardia
  7. candidiasis
  8. cholecystitis
  9. cholelithiasis
  10. coma
  11. constipation
  12. cough
  13. diarrhea
  14. dysgeusia
  15. dyspnea
  16. elevated hepatic enzymes
  17. encephalopathy
  18. erythema
  19. fever
  20. headache
  21. heart failure
  22. hypocalcemia
  23. hypokalemia
  24. injection site reaction
  25. insomnia
  26. maculopapular rash
  27. myoclonia
  28. nausea
  29. peripheral edema
  30. phlebitis
  31. pleural effusion
  32. pruritus
  33. pseudomembranous colitis
  34. rash
  35. restlessness
  36. seizures
  37. skin irritation
  38. stomatitis
  39. superinfection
  40. thrombocytosis
  41. vomiting
  42. xerostomia

Monitoring Parameters

  • serum creatinine/BUN

Contraindications

  • breast-feeding
  • carbapenem hypersensitivity
  • cephalosporin hypersensitivity
  • coagulopathy
  • dialysis
  • diarrhea
  • geriatric
  • hypoprothrombinemia
  • laboratory test interference
  • mortality
  • penicillin hypersensitivity
  • pregnancy
  • pseudomembranous colitis
  • renal failure
  • renal impairment
  • seizure disorder
  • seizures
  • vitamin K deficiency

Interactions

  • Dienogest; Estradiol valerate
  • Drospirenone
  • Drospirenone; Estradiol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Elagolix; Estradiol; Norethindrone acetate
  • Estradiol; Levonorgestrel
  • Estradiol; Norethindrone
  • Estradiol; Norgestimate
  • Ethinyl Estradiol
  • Ethinyl Estradiol; Desogestrel
  • Ethinyl Estradiol; Ethynodiol Diacetate
  • Ethinyl Estradiol; Etonogestrel
  • Ethinyl Estradiol; Levonorgestrel
  • Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Ethinyl Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestrel
  • Leuprolide; Norethindrone
  • Levonorgestrel
  • Loop diuretics
  • Mestranol; Norethindrone
  • Norethindrone
  • Norgestrel
  • Oral Contraceptives
  • Segesterone Acetate; Ethinyl Estradiol
  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
  • Warfarin

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