Cefiderocol

Antimicrobial Activity
1. Escherichia coli
2. Enterobacter cloacae complex
3. Klebsiella Pneumoniae
4. Proteus mirabilis
5. Pseudomonas
Conditions
1. Complicated, multi-drug resistant Urinary Tract Infections including Pyelonephritis

Structurally similar to Cefepime and Ceftazidime
Effective against Gram Negative aerobic Bacteria (esp. complicated Pyelonephritis)
1. Does NOT provide adequate Gram Positive or anaerobic activity
Unique mechanism compared with other Cephalosporins which enter Bacterial cells via porin channels
1. Cefiderocol enters the Bacterial cell via active iron transport
2. As with other Cephalosporins, Cefiderocol is bactericidal, inhibiting cell wall synthesis

Adult Dosing
1. Cefiderocol 2 g IV every 8 hours for 7 to 14 days
Renal Dosing
1. eGFR 30 to 59 ml/min: Give 1.5 g IV every 8 hours
2. eGFR 15 to 29 ml/min: Give 1 g IV every 8 hours
3. eGFR <15 ml/min or Hemodialysis: Give 0.75 g IV every 8 hours

Reactions
1. Hypersensitvity Reaction
2. Infusion site reaction (inflammation, redness, Pruritus)
Common adverse effects (>2% of patients)
1. Diarrhea or Constipation
2. Nausea and Vomiting
3. Rash including Candidiasis
4. Cough
5. Increased liver enzymes
6. Headache
7. Hypokalemia