New Perspectives on Antimicrobial Agents: Cefiderocol
New Perspectives on Antimicrobial Agents: Cefiderocol
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DOI：
10.1128/aac.02171-20
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发表时间：
2021-08-01
影响因子：
4.9
通讯作者：
Tamma, Pranita D.
中科院分区：
文献类型：
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作者：
McCreary, Erin K.;Heil, Emily L.;Tamma, Pranita D.
细菌对碳青霉烯类药物的耐药性已达到令人担忧的水平。因此，近年来，国家和国际组织与制药业之间的合作努力已导致市售β-内酰胺制剂的显著扩展。没有可用的代理来接近由头孢地罗可，一种新的铁载体-头孢菌素共轭物提供的广泛的活动范围。头孢地罗可的新奇和需求是明确的，但现有的临床数据是相互矛盾的，让传染病专家困惑于何时在临床实践中处方这种药物。在简要概述了头孢地罗可的药代动力学和药效学、安全性数据、头孢地罗可药敏试验以及头孢地罗可耐药的假定机制之后，本文综述了头孢地罗可在特定病原体管理中的作用，包括碳青霉烯类耐药鲍曼不动杆菌复合体、碳青霉烯类耐药铜绿假单胞菌、碳青霉烯类耐药肠球菌、和不太常见的葡萄糖非发酵生物，如嗜麦芽寡养单胞菌、伯克霍尔德氏菌属和无色杆菌属。现有的临床前，临床试验，和上市后的数据进行了总结，为每种微生物，每个部分的结论与我们的意见，在哪里定位头孢德罗作为一种临床治疗。
Bacterial resistance to carbapenem agents has reached alarming levels. Accordingly, collaborative efforts between national and international organizations and the pharmaceutical industry have led to an impressive expansion of commercially available beta-lactam agents in recent years. No available agent comes close to the broad range of activity afforded by cefiderocol, a novel siderophore-cephalosporin conjugate. The novelty of and need for cefiderocol are clear, but available clinical data are conflicting, leaving infectious diseases specialists puzzled as to when to prescribe this agent in clinical practice. After a brief overview of cefiderocol pharmacokinetics and pharmacodynamics, safety data, cefiderocol susceptibility testing, and putative mechanisms of cefiderocol resistance, this review focuses on determining cefiderocol's role in the management of specific pathogens, including carbapenem-resistant Acinetobacter baumannii complex, carbapenem-resistant Pseudomonas aeruginosa, carbapenem-resistant Enterobacterales, and less commonly identified glucose-nonfermenting organisms such as Stenotrophomonas maltophilia, Burkholderia species, and Achromobacter species. Available preclinical, clinical trial, and postmarketing data are summarized for each organism, and each section concludes with our opinions on where to position cefiderocol as a clinical therapeutic.