Witzke Oliver, Brenner Thorsten
Klinik für Infektiologie, Westdeutsches Zentrum für Infektiologie, Universitätsmedizin Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Deutschland.
Klinik für Anästhesiologie und Intensivmedizin, Universitätsmedizin Essen, Universität Duisburg-Essen, Essen, Deutschland.
Med Klin Intensivmed Notfmed. 2023 Mar;118(2):149-155. doi: 10.1007/s00063-022-00925-5. Epub 2022 Aug 1.
Infections due to antibiotic-resistant bacteria are threatening modern healthcare, and antibacterial resistance has become one of the greatest threats to public health. In Germany 54,500 patients become infected with antibiotic-resistant bacteria per year, causing about 2400 attributable deaths. Rising resistance in Gram-negative bacteria especially carbapenem-resistant pathogens is of particular concern due to the lack of effective and safe alternative treatment options.
The results from trials and compassionate-use programs with the new antibiotic cefiderocol, which was approved by the European Medicines Agency (EMA) in April 2020 for the treatment of adults with infections caused by aerobic Gram-negative bacteria, are summarized.
The new β‑lactam antibiotic cefiderocol is the first siderophore cephalosporin indicated for the treatment of infections due to aerobic Gram-negative organisms in adults with limited treatment options. Its chemical structure and its unique mechanism of action confer enhanced stability against β‑lactamases including all classes of clinically relevant carbapenemases. In vitro data show high antibacterial activity against multidrug resistant Gram-negative bacteria, Enterobacterales and nonfermenters, including carbapenem-resistant strains. In clinical trials, cefiderocol showed superiority in complicated urinary tract infection in comparison to imipenem and non-inferiority versus meropenem in hospital-acquired/ventilator-associated pneumonia patients and severe infections caused by carbapenem-resistant pathogens.
Clinical trial data and case reports identified in the literature search show that cefiderocol is a promising treatment option for severe infections caused by drug-resistant Gram-negative bacteria, particularly carbapenem-resistant bacteria.
抗生素耐药菌引起的感染正威胁着现代医疗保健，抗菌药物耐药性已成为对公众健康的最大威胁之一。在德国，每年有54500名患者感染抗生素耐药菌，导致约2400例可归因死亡。革兰氏阴性菌尤其是耐碳青霉烯病原体的耐药性不断上升，由于缺乏有效且安全的替代治疗方案，这一情况尤为令人担忧。
总结新型抗生素头孢地尔在试验和同情用药项目中的结果，该药物于2020年4月获欧洲药品管理局（EMA）批准，用于治疗由需氧革兰氏阴性菌引起感染的成人患者。
新型β-内酰胺类抗生素头孢地尔是首个被批准用于治疗治疗选择有限的成人需氧革兰氏阴性菌感染的铁载体头孢菌素。其化学结构和独特的作用机制使其对β-内酰胺酶（包括所有临床相关类别的碳青霉烯酶）具有更高的稳定性。体外数据显示，它对多重耐药革兰氏阴性菌、肠杆菌科细菌和非发酵菌（包括耐碳青霉烯菌株）具有高抗菌活性。在临床试验中，与亚胺培南相比，头孢地尔在复杂性尿路感染中显示出优势，在医院获得性/呼吸机相关性肺炎患者以及由耐碳青霉烯病原体引起的严重感染中，与美罗培南相比不劣效。
文献检索中确定的临床试验数据和病例报告表明，头孢地尔是治疗由耐药革兰氏阴性菌尤其是耐碳青霉烯细菌引起的严重感染的一种有前景的治疗选择。
