Wang Chuanhai, Yang Deqing, Wang Yifan, Ni Wentao
Department of Pulmonary and Critical Care Medicine, Shengli Oilfield Central Hospital, Dongying, China.
Department of Pharmacy, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
Front Pharmacol. 2022 Apr 12;13:896971. doi: 10.3389/fphar.2022.896971. eCollection 2022.
Cefiderocol is a novel synthetic siderophore-conjugated antibiotic that hijacks the bacterial iron transport systems facilitating drug entry into cells, achieving high periplasmic concentrations. This systematic review analyzed the currently available literature on cefiderocol. It summarized susceptibility data, antimicrobial activity, pharmacokinetics/pharmacodynamics (PK/PD), clinical efficacy, safety and resistance mechanisms of cefiderocol. Cefiderocol has potent and activity against multidrug-resistant (MDR) Gram-negative bacteria, including carbapenem-resistant isolates. But New Delhi Metallo-β-lactamase (NDM)- positive isolates showed significantly higher MICs than other carbapenemase-producing , with a susceptible rate of 83.4% for cefiderocol. Cefiderocol is well-tolerated, and the PK/PD target values can be achieved using a standard dose regimen or adjusted doses according to renal function. Clinical trials demonstrated that cefiderocol was non-inferiority to the comparator drugs in treating complicated urinary tract infection and nosocomial pneumonia. Case reports and series showed that cefiderocol was a promising therapeutic agent in carbapenem-resistant infections. However, resistant isolates and reduced susceptibility during treatment to cefiderocol have already been reported. In conclusion, cefiderocol is a promising powerful weapon for treating MDR recalcitrant infections.
头孢地尔是一种新型的合成铁载体缀合抗生素，它利用细菌的铁转运系统促进药物进入细胞，从而在周质中达到高浓度。本系统评价分析了目前关于头孢地尔的可用文献。它总结了头孢地尔的敏感性数据、抗菌活性、药代动力学/药效学（PK/PD）、临床疗效、安全性和耐药机制。头孢地尔对多重耐药（MDR）革兰氏阴性菌，包括耐碳青霉烯类菌株具有强大的活性。但新德里金属β-内酰胺酶（NDM）阳性菌株的最低抑菌浓度（MIC）显著高于其他产碳青霉烯酶菌株，头孢地尔对其敏感率为83.4%。头孢地尔耐受性良好，使用标准剂量方案或根据肾功能调整剂量可达到PK/PD目标值。临床试验表明，在治疗复杂性尿路感染和医院获得性肺炎方面，头孢地尔不劣于对照药物。病例报告和系列研究表明，头孢地尔在耐碳青霉烯类感染中是一种有前景的治疗药物。然而，已经有关于头孢地尔耐药菌株和治疗期间敏感性降低的报道。总之，头孢地尔是治疗MDR难治性感染的一种有前景的有力武器。
