Francisco López Medrano. Unit of Infectious Diseases. Hospital Universitario "12 de Octubre". Madrid, Spain.
Rev Esp Quimioter. 2021 Sep;34 Suppl 1(Suppl1):41-43. doi: 10.37201/req/s01.12.2021. Epub 2021 Sep 30.
Cefiderocol is a novel catechol-substituted siderophore cephalosporin that binds to the extracellular free iron, and uses the bacterial active iron transport channels to penetrate in the periplasmic space of Gram-negative bacteria (GNB). Cefiderocol overcomes many resistance mechanisms of these bacteria. Cefiderocol is approved for the treatment of complicated urinary tract infections, hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia in the case of adults with limited treatment options, based on the clinical data from the APEKS-cUTI, APEKS-NP and CREDIBLE-CR trials. In the CREDIBLE-CR trial, a higher all-cause mortality was observed in the group of patients who received cefiderocol, especially those with severe infections due to Acinetobacter spp. Further phase III clinical studies are necessary in order to evaluate cefiderocol´s efficacy in the treatment of serious infections.
头孢地尔罗是一种新型儿茶酚取代的铁载体头孢菌素，可与细胞外游离铁结合，并利用细菌主动铁转运通道穿透革兰氏阴性菌（GNB）的周质空间。头孢地尔罗克服了这些细菌的许多耐药机制。基于 APEKS-cUTI、APEXS-NP 和 CREDIBLE-CR 试验的临床数据，头孢地尔罗被批准用于治疗成人有限治疗选择的复杂尿路感染、医院获得性细菌性肺炎和呼吸机相关性细菌性肺炎。在 CREDIBLE-CR 试验中，接受头孢地尔罗治疗的患者全因死亡率较高，尤其是因不动杆菌属引起的严重感染患者。为了评估头孢地尔罗在严重感染治疗中的疗效，还需要进行进一步的 III 期临床研究。
