Cefiderocol, caballo de troya en la infección por bacilos gramnegativos multirresistentes

Resumo

Objective: Narrative review of the evidence of clinical efficacy and safety of cefiderocol, a new cephalosporin with activity against carbapenemase-producing enterobacteria and beta-lactam-resistant non-fermenting gram-negative bacilli, and to locate its place in therapy. Material and methods: Search in PubMed with the keyword cefiderocol. Records were limited to those in English and Spanish language. Papers that reported its use in clinical practice and clinical trial database websites were selected. Results: The search resulted in 3 clinical trials, 4 series between 3 and 10 patients, and 10 case-report. In randomized clinical trials, cefiderocol was shown to be non-inferior to comparator agents in infections complicated by gram-negative bacilli, without significant adverse effects. In CREDIBLE-CR study, mortality was higher in the cefiderocol group compared to best available therapy group. Published case series include rescue therapies in critically ill, burned, and cystic fibrosis patients with multiresistant gram-negative bacilli infections. Conclusions: Cediferocol has demonstrated clinical efficacy and safety and constitutes an alternative in the treatment of infections caused by gram-negative bacilli resistant to betalactams.