Additionally, plazomicin, a novel aminoglycoside, displays enhanced activity against Enterobacterales, including CRE.

aeruginosa (ceftolozane/tazobactam, ceftazidime/avibactam, imipenem/relebactam), and KPC-producing (ceftazidime/avibactam, meropenem/vaborbactam, and imipenem/relebactam) and OXA-48-like (ceftazidime/avibactam) carbapenem-resistant Enterobacterales (CRE). Most recent additions to the armamentarium have targeted activity against MDR P. While the antimicrobial pipeline has recently produced a number of game-changing agents, gaps in the armory are still present. Unfortunately, these agents possess significant disadvantages, including toxicities, sub-optimal pharmacokinetics at target sites of infection, and poor outcome data. Historically, antibiotic options for multi-drug resistant (MDR) Gram-negative infections have included aminoglycosides, polymyxins, and/or tigecycline. The presence of multi-drug resistance complicates the management of these infections due to the limited treatment options available.

These Gram-negative organisms are common pathogens in a variety of serious infections, including intra-abdominal infections, pneumonia, urinary tract infections, and bloodstream infections (BSI). The emergence of carbapenem resistance in Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumannii is an urgent threat to global public health. The purpose of this article is to review existing data on the mechanism of action, microbiology, pharmacokinetics, pharmacodynamics, efficacy, and safety of cefiderocol to assist clinicians in determining its place in therapy. Cefiderocol recently received US Food and Drug Administration approval for the treatment of complicated urinary tract infections, including pyelonephritis, and is currently being evaluated in phase III trials for nosocomial pneumonia and infections caused by carbapenem-resistant Gram-negative pathogens. CefiderocolвЂ™s spectrum of activity encompasses both lactose-fermenting and non-fermentingВ Gram-negative pathogens, including carbapenem-resistant Enterobacterales. This structure and its unique mechanism of action confer enhanced stability against hydrolysis by many ОІ-lactamases, including extended spectrum ОІ-lactamases such as CTX-M, and carbapenemases such as KPC, NDM, VIM, IMP, OXA-23, OXA-48-like, OXA-51-like and OXA-58. Cefiderocol, formerly S-649266, is a first in its class, an injectable siderophore cephalosporin that combines a catechol-type siderophore and cephalosporin core with side chains similar to cefepime and ceftazidime.

Aztreonam affinity for pbp3