An Overview of Cefiderocol’s Therapeutic Potential and Underlying Resistance Mechanisms

Antimicrobial resistance continues to increase globally and treatment of difficult-to-treat (DTT) infections, mostly associated with carbapenem-resistant (CR) Pseudomonas aeruginosa, CR Acinetobacter baumannii, CR- third-generation-cephalosporins-resistant Enterobacterales remains a challenge for the clinician. The recent approval cefiderocol has broaden armamentarium patients DTT infections. Cefiderocol is siderophore cephalosporin that shown excellent antibacterial activity, in part due its innovative way cell permeation. It relatively stable compared most commonly found carbapenamases. However, some resistant mechanisms have already been identified reduced susceptibility developed during patient treatment, highlighting clinical use must be rational. In this review, we summarize current available treatments against former bacteria, revise discuss mechanism action cefiderocol, underlying biological function siderophores, therapeutic potential reported so far.